aero.owl
type: Ontology
contributor: Alan Ruttenberg
contributor: Melanie Courtot
comment: The Adverse Event Reporting Ontology (AERO) is designed to facilitate the representation of adverse event reports and their evaluation in relation to clinical guidelines written by various authorities. We take a realist approach in which findings in reports are information artifacts and are related to instances or types that represent patient, symptoms, diseases, etc. We intend that use of this ontology will result in data that interoperates well with OBO Foundry ontologies as we directly use terms from OBO ontologies wherever appropriate. The initial domain for this work are reports of adverse events following immunization (AEFIs). We represent the Brighton case definitions as our guidelines, show how findings can be assessed in terms of Brighton criteria and how diagnoses of adverse events with different levels of certainty can be obtained by use of the OWL reasoner.
imports: iao.owl
imports: OMRE AEROImport.owl
imports: external-by-hand.owl
imports: external.owl
imports: externalDerived.owl

BrightonFormula
type: AnnotationProperty
IAO_0000112: SuddOnset = sudden onset
IAO_0000115: An annotation property reflecting the string used by Brighton in their ABC tool to encode the term
IAO_0000112: AngEdGenLoc - angioedema, localized or generalized

PHAC definition
type: AnnotationProperty
IAO_0000115: The definition of the term as formalized in the PHAC user guide, http://www.phac-aspc.gc.ca/im/pdf/AEFI-ug-gu-eng.pdf. Those definitions are often very specific to adverse event following immunization and are intended for reporting personel.

found to exhibit
type: ObjectProperty
IAO_0000116: A funny kind of relation, as there is a sense in which this is really a made up relation so we can speak from a patient centric point of view. Really, the relation is established in the inverse direction - a process in which a patient or information about the patient is assessed leads to a finding about the patient.
IAO_0000117: Alan Ruttenberg
IAO_0000115: if something is 'found to exhibit' a clinical finding, then there is a clinical finding 'that 'is clinical finding about' that something.

has component
type: ObjectProperty
IAO_0000112: a VAERS report has_component MedDRA term 12345
IAO_0000115: indicates the constitutive elements of a document/guideline/specification.
sub property of: has part

involves
type: ObjectProperty
comment: 20101115, MC: one difiiculty in defining this relation is how to "cut" the chain at the first system involved. Example (from AR): a patient has a stroke in a nexk artery, which causes brain damage. We would still say "stroke involves cardiovascular system" and NOT "stroke involves nervous system"
IAO_0000115: A relation between a clinical finding and the anatomical system or entity in which it takes place, at least partly.
domain: OGMS_0000014
range: MaterialEntity

is clinical finding about
type: ObjectProperty
IAO_0000112: A clinician records a finding that the patient has nausea
IAO_0000115: Relates a clinical finding to the patient or part about which the finding was made.
IAO_0000112: a finding is made that the heart has a malfunctioning valve
inverse of: found to exhibit
sub property of: IAO_0000136
domain: OGMS_0000014
range: Restriction
  on property: part of
  some values from: patient

realizes
type: ObjectProperty

begins to exist during
type: ObjectProperty
sub property of: participates in

located at
type: ObjectProperty

diagnosis guideline
type: Class
subclass of: IAO_0000033
IAO_0000115: A directive information entity that specifies how to establish a diagnosis based on clinical findings

disorder resulting from an AEFI process
type: Class
equivalent class: Class
  intersection of: disorder resulting from an adverse event process
  intersection of: Restriction
    on property: OBI_0000312
    some values from: adverse event following immunization process
subclass of: disorder resulting from an adverse event process
comment: MC, 20110120: AR mentioned that the use of is_specified_output is not appropriate, as this would indicate that the adverse event process is a planned process - specified output are things that are specified in the plan to realize a process. Adverse events are not planned process but processual entities, and therefore this should be updated. AR mentioned that BFO will include an appropriate relation.
comment: MC, 20110120: This class should have a different label for OBO Foundry unique label. "adverse event following immunization" is a term in use by the clinician community, however in the context if the Foundry it may be confusing to associate the word "event" which seem to refer to a process with the hierarchical position under continuant. Proposed OBO Foundry label: disorder resulting from an AEFI
comment: MC, 20110126: class renamed from "adverse event following immunization continuant" following AR suggestion

Brighton case definition
type: Class
subclass of: diagnosis guideline
IAO_0000115: A diagnosis guideline specifying how to establish a diagnosis of adverse event with an associated degree of certainty, as developed by the Brighton Collaboration, http://www.brightoncollaboration.org/
comment: MC, 20110126: this should be linked to the different adverse events reported. AR suggests using a new relation to appear in BFO2, maybe "ascription"

Brighton diagnosis of generalized convulsive seizure as an adverse event following immunization
type: Class
subclass of: Brighton diagnosis result
subclass of: Restriction
  on property: IAO_0000136
  some values from: adverse event
IAO_0000119: PMID:14741144#Generalized convulsive seizure as an adverse event following immunization: case definition and guidelines for data collection, analysis, and presentation.
comment: 20121115, MC: originally "a categorical measurement datum whose instances are used to classify adverse events according to whether or not they have some likelihood of being a seizure and if so, to what degree"

disorder resulting from an adverse event process
type: Class
equivalent class: Class
  intersection of: OGMS_0000045
  intersection of: Restriction
    on property: begins to exist during
    some values from: adverse event process
comment: MC, 20110120: AR mentioned that the use of is_specified_output is not appropriate, as this would indicate that the adverse event process is a planned process - specified output are things that are specified in the plan to realize a process. Adverse events are not planned process but processual entities, and therefore this should be updated. AR mentioned that BFO will include an appropriate relation.
comment: MC, 20110120: This class was initially labeled "adverse event continuant". After discussion with AR, and due to the fact that the word "event" implicitely refers to a process, we renamed this class.

adverse event
type: Class
equivalent class: Class
  union of: disorder resulting from an adverse event process
  union of: adverse event process
IAO_0000119: ICH Topic E 2 A Clinical Safety Data Management: Definitions and Standards for Expedited Reporting
IAO_0000115: An adverse event is an undesirable, unfavorable and unintended medical occurrence presenting in a predetermined time frame following administration of a compound or usage of a device
comment: I initialy made adverse event a defined class: is_a sign and preceded by administration. However, by doing so, and as the range of preceded by is processual entities, I was implicitely making adverse event a subclass of processual entity, therfore making adverse event rash (a continuant) inconsistent.

adverse event following immunization
type: Class
equivalent class: Class
  union of: disorder resulting from an AEFI process
  union of: adverse event following immunization process
subclass of: adverse event
IAO_0000119: Adapted from ICH Topic E 2 A Clinical Safety Data Management: Definitions and Standards for Expedited Reporting
IAO_0000115: An adverse event is an undesirable, unfavorable and unintended medical occurrence presenting in a predetermined time frame following administration of a vaccine

_manifestations
type: Class
subclass of: OGMS_0000014
disjoint with: rapid progression
disjoint with: generalized urticaria or generalized erythema finding
disjoint with: generalized pruritus with skin rash finding
disjoint with: capillary refill time > 3s finding
disjoint with: increased use of accessory respiratory muscles finding
disjoint with: grunting finding
disjoint with: hoarse voice finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: itchy eyes finding
disjoint with: pruritus finding
comment: temporary placeholder - to be removed This class just helps me group some terms during development of the structure

AEFI idiopathic thrombocytopenic purpura according to Brighton
type: Class
subclass of: _manifestations
IAO_0000115: Idiopathic thrombocytopenic purpura (ITP) is the condition of having a low platelet count (thrombocytopenia) of no known cause (idiopathic).v
IAO_0000119: http://en.wikipedia.org/wiki/Idiopathic_thrombocytopenic_purpura

AEFI encephalitis according to Brighton
type: Class
subclass of: _manifestations
subclass of: Restriction
  on property: involves
  some values from: UBERON_0000955
IAO_0000115: Encephalitis is an inflammation of the brain. It may be caused by a number of different factors. One of the most common causes is direct infection of the brain by a virus or bacterium. Inflammation can also occur as a complication of some other disorder, such as mumps (see mumps entry) or herpes simplex (see herpes infections entry).
IAO_0000119: http://www.faqs.org/health/Sick-V2/Encephalitis-Definition.html

motor manifestation
type: Class
subclass of: _manifestations
IAO_0000115: A _manifestation involving the motor system

adverse event process
type: Class
equivalent class: Class
  intersection of: ProcessualEntity
  intersection of: Restriction
    on property: preceded by
    some values from: Class
      union of: OBI_0000274
      union of: OBI_0600007
IAO_0000115: An adverse event process is a processual entity occurring in a pre determined time frame following administration of a compound or usage of a device
comment: I included the usage of a device into the definition of adverse event as I am aiming at being inclusive, and cover cases such as those described by MAUDE - Manufacturer and User Facility Device Experience. See for example http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/detail.cfm?mdrfoi__id=1942591 - a patient get fitted with bioprosthetic heart valves and dies within the following 4 months.
comment: Note that this definition of adverse event doesn't imply any type of causality between the sign observed and the coumpond administration/device utilization. For our purposes, we consider any type of sign presenting within a specific time frame after the coumpound administration/device utilization to be an adverse event.

adverse event following immunization process
type: Class
equivalent class: Class
  intersection of: adverse event process
  intersection of: Restriction
    on property: preceded by
    some values from: VO_0000002
subclass of: adverse event process

seizure level 1 of certainty according to the Brighton criteria
type: Class
equivalent class: Class
  intersection of: Restriction
    on property: has component
    some values from: witnessed sudden loss of consciousness finding
  intersection of: Restriction
    on property: has component
    some values from: Class
      union of: generalized atonic motor manifestation finding
      union of: generalized clonic motor manifestation finding
      union of: generalized tonic motor manifestation finding
      union of: generalized tonic-clonic motor manifestation finding
subclass of: Brighton diagnosis of generalized convulsive seizure as an adverse event following immunization
comment: MC, 20110126: this needs to be linked to the Brighton guideline defined under directive information entity
IAO_0000115: witnessed sudden loss of consciousness AND generalized, tonic, clonic, tonic–clonic, or atonic motor manifestations. (atonic In the absence of: hypotonic hyporesponsive episode (as deﬁned by the Brighton Collaboration), syncope, and myoclonic jerks.

seizure level 2 of certainty according to the Brighton criteria
type: Class
equivalent class: Class
  intersection of: Restriction
    on property: has component
    some values from: history of unconsciousness
  intersection of: Restriction
    on property: has component
    some values from: Class
      union of: generalized atonic motor manifestation finding
      union of: generalized clonic motor manifestation finding
      union of: generalized tonic motor manifestation finding
      union of: generalized tonic-clonic motor manifestation finding
subclass of: Brighton diagnosis of generalized convulsive seizure as an adverse event following immunization
comment: MC, 20110126: this needs to be linked to the Brighton guideline defined under directive information entity
IAO_0000115: history of unconsciousness AND generalized, tonic, clonic, tonic–clonic, or atonic motor manifestations. (atonic In the absence of: hypotonic hyporesponsive episode (as deﬁned by the Brighton Collaboration), syncope, and myoclonic jerks.

seizure level 3 of certainty according to the Brighton criteria
type: Class
equivalent class: Class
  intersection of: Restriction
    on property: has component
    some values from: generalized motor manifestation finding
  intersection of: Restriction
    on property: has component
    some values from: history of unconsciousness
subclass of: Brighton diagnosis of generalized convulsive seizure as an adverse event following immunization
comment: MC, 20110126: this needs to be linked to the Brighton guideline defined under directive information entity
IAO_0000115: history of unconsciousness AND other generalized motor manifestations.

atonic motor manifestation finding
type: Class
subclass of: motor manifestation
IAO_0000115: A sudden loss of tone in postural muscle, often preceded by a myoclonic jerk and precipitated by hyperventilation
IAO_0000119: Brighton Collaboration, http://www.brightoncollaboration.org/

generalized atonic motor manifestation finding
type: Class
equivalent class: Class
  intersection of: atonic motor manifestation finding
  intersection of: generalized motor manifestation finding
subclass of: atonic motor manifestation finding

clonic motor manifestation finding
type: Class
subclass of: motor manifestation
IAO_0000119: Brighton Collaboration, http://www.brightoncollaboration.org/
IAO_0000115: Sudden, brief (100ms) involuntary contractions of the same muscle groups, regularly repetitive at a frequency of about two to three contractions per second.

generalized motor manifestation finding
type: Class
subclass of: motor manifestation
IAO_0000119: Brighton Collaboration, http://www.brightoncollaboration.org/
IAO_0000115: bilateral motor manifestation, more than minimal muscle involvement

generalized clonic motor manifestation finding
type: Class
equivalent class: Class
  intersection of: clonic motor manifestation finding
  intersection of: generalized motor manifestation finding

generalized tonic motor manifestation finding
type: Class
equivalent class: Class
  intersection of: generalized motor manifestation finding
  intersection of: tonic motor manifestation finding

generalized tonic-clonic motor manifestation finding
type: Class
equivalent class: Class
  intersection of: clonic motor manifestation finding
  intersection of: generalized motor manifestation finding
  intersection of: tonic motor manifestation finding

AEFI hypotonic-hyporesponsive episode according to Brighton
type: Class
subclass of: _manifestations
IAO_0000118: HHE
IAO_0000115: HHE is characterized by sudde onset of reduced muscle tone, hyporesponsiveness (i.e., less responsive than usual to verbal or other sensorial stimuli) and change of skin color (pallor or cyanosis)

performing a diagnosis of generalized convulsive seizure according to Brighton guidelines
type: Class
equivalent class: Restriction
  on property: realizes
  some values from: Restriction
    on property: OBI_0000294
    all values from: Brighton case definition of generalized convulsive seizure as an adverse event following immunization
subclass of: performing a diagnosis according to a Brighton case definition
subclass of: Restriction
  on property: OBI_0000299
  some values from: Brighton diagnosis of generalized convulsive seizure as an adverse event following immunization
IAO_0000115: performing a diagnosis specified by the Brighton case definition for convulsive seizure as an adverse event following immunization

Brighton case definition of generalized convulsive seizure as an adverse event following immunization
type: Class
subclass of: Brighton case definition
subclass of: Restriction
  on property: OBI_0000297
  some values from: Restriction
    on property: OBI_0000300
    all values from: performing a diagnosis of generalized convulsive seizure according to Brighton guidelines
IAO_0000115: A Brighton case definition of generalized convulsive seizure as an adverse event following immunization
IAO_0000119: PMID:14741144#Generalized convulsive seizure as an adverse event following immunization: case definition and guidelines for data collection, analysis, and presentation.

shaking finding
type: Class
subclass of: motor manifestation
IAO_0000118: quivering
IAO_0000115: repetitive, cyclical movements of the body or a body part; usually involuntary, but can also manifest in response to an attempt at movement
IAO_0000118: shivering
IAO_0000118: trembling
IAO_0000118: tremor

bilateral shaking finding
type: Class
equivalent class: Class
  intersection of: shaking finding
  intersection of: Restriction
    on property: unfolds in
    all values from: bilateral site
subclass of: shaking finding
IAO_0000115: A shaking process which unfolds in both sides of an organism

syncope finding
type: Class
subclass of: motor manifestation
comment: MC, 20110126: The Brighton guideline on which this is based needs to be checked. Email correspondance with Brighton: [MC] One thing is unclear to me: Level 1 of diagnostic certainty is defined as "witnessed sudden loss of consciousness AND generalized, tonic, clonic, tonicâclonic, or atonic motor manifestations." A footnote adds: atonic in the absence of: hypotonic hyporesponsive episode (as deï¬ned by the Brighton Collaboration), syncope, and myoclonic jerks. If we define syncope as being a loss of consciousness, how can I have a witnessed sudden loss of consciousness and a generalized atonic motor manifestation in the absence of syncope? [Brighton] Thank you for your question. You are right, that there is an overlap between the clinical presentation of an atonic seizure and a Syncope. This is also true for HHE. This is the very reasonf or the footnote to alert the user of the definition to this differential diagnosis. If you are working on a database and only have the clinical criteria vailable, you may have some false positives for the atonic seizure cases, unless you obtain additional information, e.g. that the Syncope was vasovagal or orthostatic, or arrhythmic, etc.
IAO_0000119: http://en.wikipedia.org/wiki/Syncope_%28medicine%29
IAO_0000115: loss of consciousness, fainting

myoclonic jerk finding
type: Class
subclass of: motor manifestation
IAO_0000115: A myoclonic jerk is the brief, involuntary twitching of a muscle or group of muscles. It may be caused either by a sudden muscle contraction, or a sudden lapse of contraction. This happens when a person is on the verge of falling asleep, and suddenly have a sensation or feeling that they are free falling through the air. Contractions are called positive myoclonus; relaxations are called negative myoclonus. When falling asleep, it is common for people to experience a type of myoclonic jerk known as a hypnic jerk. Hiccups are also a kind of myoclonic jerk specifically affecting the diaphragm.
IAO_0000119: http://house.wikia.com/wiki/Myoclonic_jerk

tonic motor manifestation finding
type: Class
subclass of: motor manifestation
subclass of: Restriction
  on property: has component
  some values from: Class
    intersection of: tonic motor manifestation finding
    intersection of: Restriction
      on property: precedes
      all values from: clonic motor manifestation finding
IAO_0000115: A sustained increase in muscle contraction lasting a few seconds to minutes

loss of consciousness finding
type: Class
subclass of: decreased level of consciousness finding
PHAC definition: Total suspension of conscious relationship with the outside world demonstrated by the inability to perceive and to respond to verbal, visual, and painful stimulus
IAO_0000119: Vaccine 28 (2010) 4487-4498

history of unconsciousness
type: Class
subclass of: loss of consciousness finding
IAO_0000119: Brighton Collaboration, http://www.brightoncollaboration.org/
comment: MC, 20110126: AR suggest that "history of consciousness is not a process. definition reads "the sudden loss of consciousness was not observed, but the patient was found unconscious", so maybe updating the label would be better : "unwitnessed loss of consciousness with history of unconsciousness" would help
IAO_0000115: the sudden loss of consciousness was not observed, but the patient was found unconscious

witnessed sudden loss of consciousness finding
type: Class
subclass of: history of unconsciousness
IAO_0000119: Brighton Collaboration, http://www.brightoncollaboration.org/

bilateral site
type: Class
subclass of: Site
subclass of: Restriction
  on property: BFO_0000086
  some values from: OMRE_0000137

witness role
type: Class
subclass of: Role
IAO_0000115: A role inhering in a person that is realized when the bearer sees an event and reports what happened
IAO_0000119: adapted from http://golovchenko.org/cgi-bin/wnsearch?q=witness

adverse side effect
type: Class
subclass of: adverse event
IAO_0000115: side effect is an adverse event of a type that has been determined by a review board to be causally related to the intervention.
comment: while in some cases the particular may not be actually caused by the intervention, it is an adverse side effect nonetheless.

device malfunction
type: Class
subclass of: ProcessualEntity
subclass of: Restriction
  on property: OBI_0000293
  some values from: OBI_0000968
IAO_0000115: A process in which the device doesn't perform as expected
IAO_0000111: device malfunction

adverse event report
type: Class
subclass of: IAO_0000088
subclass of: Restriction
  on property: IAO_0000136
  some values from: Class
    union of: adverse event
    union of: device malfunction
subclass of: Restriction
  on property: OBI_0000312
  some values from: adverse event reporting process
IAO_0000115: A report as submitted in an adverse event reporting system
IAO_0000116: MC, 20110719: not all adverse event report are about adverse event. See for example cases in MAUDE database that are about potential adverse events such as device malfunctions.
IAO_0000111: adverse event report

reporting process
type: Class
subclass of: ProcessualEntity
subclass of: Restriction
  on property: OBI_0000299
  some values from: IAO_0000088
IAO_0000115: The process of creating documentation about something and adding it to a system allowing further analysis of the reported entity

sudden onset
type: Class
subclass of: OGMS_0000014
disjoint with: rapid progression
disjoint with: Brighton diagnosis result
disjoint with: generalized urticaria or generalized erythema finding
disjoint with: angioedema finding
disjoint with: capillary refill time > 3s finding
disjoint with: cyanosis finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
BrightonFormula: SuddOnset
IAO_0000119: Anaphylaxis: Case definition and guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 25 (2007) 5675–5684
IAO_0000115: The term sudden onsets refers to an event that occurred unexpectedly and without warning leading to a marked change in a subjects previously stable condition

rapid progression
type: Class
subclass of: OGMS_0000014
disjoint with: respiratory distress diagnosis
disjoint with: Brighton diagnosis result
disjoint with: clinical diagnosis of uncompensated shock
disjoint with: dermatologic or mucosal sign
disjoint with: generalized urticaria or generalized erythema finding
disjoint with: angioedema finding
disjoint with: generalized pruritus with skin rash finding
disjoint with: measured hypotension finding
disjoint with: uncompensated shock sign finding
disjoint with: tachycardia finding
disjoint with: capillary refill time > 3s finding
disjoint with: reduced central pulse volume finding
disjoint with: stridor finding
disjoint with: upper airway swelling finding
disjoint with: tachypnoea finding
disjoint with: increased use of accessory respiratory muscles finding
disjoint with: recession finding
disjoint with: cyanosis finding
disjoint with: grunting finding
disjoint with: respiratory distress sign finding
disjoint with: red and itchy eyes finding
disjoint with: reduced peripheral circulation finding
disjoint with: reduced peripheral circulation diagnosis
disjoint with: hoarse voice finding
disjoint with: sensation of throat closure finding
disjoint with: sneezing or rhinorrhea finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: nausea finding
disjoint with: vomiting finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: cardiovascular sign
disjoint with: respiratory sign
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: indrawing finding
disjoint with: rhinorrhea finding
disjoint with: sore throat finding
disjoint with: wheezing finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: itchy eyes finding
disjoint with: prickle sensation finding
disjoint with: pruritus finding
disjoint with: rash finding
disjoint with: urticaria finding
disjoint with: decreased level of consciousness finding
disjoint with: sneezing finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075
BrightonFormula: RapidProgr
IAO_0000119: Anaphylaxis: Case definition and guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 25 (2007) 5675–5684
IAO_0000115: The term rapid progression is a conventional clinical term. An exact timeframe sould not be offered since it would have to refer to a wide range of signs and symptoms without a scientific evidence base. Using an arbitrarily restrictive setpoint might bias future data collection unnecessarily.

respiratory distress diagnosis
type: Class
equivalent class: Class
  intersection of: Restriction
    on property: has component
    on class: respiratory distress sign finding
    min qualified cardinality: 2
  intersection of: Restriction
    on property: has component
    on class: tachypnoea finding
    max qualified cardinality: 1
  intersection of: Restriction
    on property: has component
    on class: increased use of accessory respiratory muscles finding
    max qualified cardinality: 1
  intersection of: Restriction
    on property: has component
    on class: recession finding
    max qualified cardinality: 1
  intersection of: Restriction
    on property: has component
    on class: cyanosis finding
    max qualified cardinality: 1
  intersection of: Restriction
    on property: has component
    on class: grunting finding
    max qualified cardinality: 1
subclass of: OGMS_0000014
disjoint with: Brighton diagnosis result
disjoint with: generalized urticaria or generalized erythema finding
disjoint with: generalized pruritus with skin rash finding
disjoint with: capillary refill time > 3s finding
disjoint with: hoarse voice finding
disjoint with: diarrhoea finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: itchy eyes finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
IAO_0000115: respiratory distress—2 or more of the following: • tachypnoea • increased use of accessory respiratory muscles (sternocleidomastoid, intercostals, etc.) • recession • cyanosis • grunting

performing a diagnosis according to a Brighton case definition
type: Class
equivalent class: Restriction
  on property: realizes
  some values from: Restriction
    on property: OBI_0000294
    some values from: Brighton case definition
subclass of: OBI_0000988

Brighton diagnosis result
type: Class
subclass of: OGMS_0000014
disjoint with: clinical diagnosis of uncompensated shock
disjoint with: dermatologic or mucosal sign
disjoint with: generalized urticaria or generalized erythema finding
disjoint with: angioedema finding
disjoint with: generalized pruritus with skin rash finding
disjoint with: measured hypotension finding
disjoint with: uncompensated shock sign finding
disjoint with: tachycardia finding
disjoint with: capillary refill time > 3s finding
disjoint with: reduced central pulse volume finding
disjoint with: stridor finding
disjoint with: upper airway swelling finding
disjoint with: tachypnoea finding
disjoint with: increased use of accessory respiratory muscles finding
disjoint with: recession finding
disjoint with: cyanosis finding
disjoint with: grunting finding
disjoint with: respiratory distress sign finding
disjoint with: red and itchy eyes finding
disjoint with: reduced peripheral circulation diagnosis
disjoint with: generalized pruritus without skin rash finding
disjoint with: hoarse voice finding
disjoint with: sensation of throat closure finding
disjoint with: sneezing or rhinorrhea finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: nausea finding
disjoint with: vomiting finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: cardiovascular sign
disjoint with: respiratory sign
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: indrawing finding
disjoint with: rhinorrhea finding
disjoint with: sore throat finding
disjoint with: wheezing finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: itchy eyes finding
disjoint with: prickle sensation finding
disjoint with: pruritus finding
disjoint with: rash finding
disjoint with: urticaria finding
disjoint with: decreased level of consciousness finding
disjoint with: sneezing finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075
IAO_0000115: The diagnosis performed upon review of an adverse event report according to the Brighton case definitions

adverse event reporting process
type: Class
subclass of: reporting process
subclass of: Restriction
  on property: OBI_0000299
  some values from: adverse event report
IAO_0000115: The process of creating documentation about an adverse event and adding it to a system allowing further analysis of the event

clinical diagnosis of uncompensated shock
type: Class
equivalent class: Class
  intersection of: Restriction
    on property: has component
    on class: uncompensated shock sign finding
    min qualified cardinality: 3
  intersection of: Restriction
    on property: has component
    on class: tachycardia finding
    max qualified cardinality: 1
  intersection of: Restriction
    on property: has component
    on class: capillary refill time > 3s finding
    max qualified cardinality: 1
  intersection of: Restriction
    on property: has component
    on class: reduced central pulse volume finding
    max qualified cardinality: 1
  intersection of: Restriction
    on property: has component
    on class: decreased level of consciousness or loss of consciousness finding
    max qualified cardinality: 1
subclass of: OGMS_0000014
disjoint with: generalized urticaria or generalized erythema finding
disjoint with: grunting finding
disjoint with: diarrhoea finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: difficulty breathing finding
IAO_0000115: combination of at least 3 of the following: - tachycardia - capillary refill time > 3s - reduced central pulse volume - decreased level of consciousness or loss of consciousness

dermatologic or mucosal sign
type: Class
equivalent class: Class
  intersection of: OGMS_0000014
  intersection of: Restriction
    on property: involves
    some values from: UBERON_0012125
disjoint with: capillary refill time > 3s finding
disjoint with: grunting finding
disjoint with: hoarse voice finding
disjoint with: diarrhoea finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
IAO_0000115: A clinical finding that involves the dermatological-mucosal system

token
type: Class

respiratory-distress-token
type: Class
subclass of: token

uncompensated-shock-token
type: Class
subclass of: token

Brighton case definition of anaphylaxis as an adverse event following immunization
type: Class
subclass of: Brighton case definition
IAO_0000119: PMID:17448577#Anaphylaxis: case definition and guidelines for data collection, analysis, and presentation of immunization safety data.

performing a diagnosis of anaphylaxis according to Brighton guidelines
type: Class
equivalent class: Restriction
  on property: realizes
  some values from: Restriction
    on property: OBI_0000294
    some values from: Brighton case definition of anaphylaxis as an adverse event following immunization
subclass of: performing a diagnosis according to a Brighton case definition
subclass of: Restriction
  on property: OBI_0000299
  some values from: Brighton diagnosis of anaphylaxis as an adverse event following immunization

major dermatological criterion for anaphylaxis according to Brighton
type: Class
subclass of: _anaphylaxis according to Brighton criteria set of clinical findings
disjoint with: grunting finding
disjoint with: diarrhoea finding
disjoint with: dry cough finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
disjoint union of: angioedema finding
disjoint union of: generalized pruritus with skin rash finding
disjoint union of: generalized erythema finding
disjoint union of: generalized urticaria finding

generalized urticaria or generalized erythema finding
type: Class
equivalent class: Class
  union of: generalized erythema finding
  union of: generalized urticaria finding
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
subclass of: Class
  union of: Restriction
    on property: IAO_0000136
    some values from: OMRE_0000103
  union of: Restriction
    on property: IAO_0000136
    some values from: OMRE_0000104
disjoint with: angioedema finding
disjoint with: generalized pruritus with skin rash finding
disjoint with: major cardiovascular criterion for anaphylaxis according to Brighton
disjoint with: major respiratory criterion for anaphylaxis according to Brighton
disjoint with: measured hypotension finding
disjoint with: uncompensated shock sign finding
disjoint with: tachycardia finding
disjoint with: capillary refill time > 3s finding
disjoint with: reduced central pulse volume finding
disjoint with: stridor finding
disjoint with: upper airway swelling finding
disjoint with: tachypnoea finding
disjoint with: increased use of accessory respiratory muscles finding
disjoint with: recession finding
disjoint with: cyanosis finding
disjoint with: grunting finding
disjoint with: respiratory distress sign finding
disjoint with: reduced peripheral circulation finding
disjoint with: reduced peripheral circulation diagnosis
disjoint with: hoarse voice finding
disjoint with: sensation of throat closure finding
disjoint with: sneezing or rhinorrhea finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: nausea finding
disjoint with: vomiting finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: minor dermatological criterion for anaphylaxis according to Brighton
disjoint with: minor cardiovascular criterion for anaphylaxis according to Brighton
disjoint with: minor respiratory criteria set for anaphylaxis according to Brighton
disjoint with: minor gastrointestinal criterion for anaphylaxis according to Brighton
disjoint with: minor laboratory criteria set for anaphylaxis according to Brighton
disjoint with: cardiovascular sign
disjoint with: respiratory sign
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: indrawing finding
disjoint with: rhinorrhea finding
disjoint with: sore throat finding
disjoint with: wheezing finding
disjoint with: red eyes finding
disjoint with: itchy eyes finding
disjoint with: prickle sensation finding
disjoint with: pruritus finding
disjoint with: rash finding
disjoint with: decreased level of consciousness finding
disjoint with: sneezing finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075

angioedema finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000105
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
disjoint with: generalized pruritus with skin rash finding
disjoint with: major cardiovascular criterion for anaphylaxis according to Brighton
disjoint with: major respiratory criterion for anaphylaxis according to Brighton
disjoint with: measured hypotension finding
disjoint with: uncompensated shock sign finding
disjoint with: tachycardia finding
disjoint with: capillary refill time > 3s finding
disjoint with: reduced central pulse volume finding
disjoint with: stridor finding
disjoint with: upper airway swelling finding
disjoint with: tachypnoea finding
disjoint with: increased use of accessory respiratory muscles finding
disjoint with: recession finding
disjoint with: cyanosis finding
disjoint with: grunting finding
disjoint with: respiratory distress sign finding
disjoint with: reduced peripheral circulation finding
disjoint with: generalized pruritus without skin rash finding
disjoint with: hoarse voice finding
disjoint with: sensation of throat closure finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: nausea finding
disjoint with: vomiting finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: indrawing finding
disjoint with: rhinorrhea finding
disjoint with: sore throat finding
disjoint with: wheezing finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: itchy eyes finding
disjoint with: prickle sensation finding
disjoint with: pruritus finding
disjoint with: rash finding
disjoint with: urticaria finding
disjoint with: decreased level of consciousness finding
disjoint with: sneezing finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075
comment: 20130423, MC: in the anaphylaxis case definition, angioedeme can be localized or generalized. There was no need as of today to create specialized subclasses representing those.
BrightonFormula: AngEdGenLoc
PHAC definition: Areas of deeper swelling of the skin and/or mucosal tissues in either single or multiple sites which may not be well circumscribed and is usually not itchy. Reported symptoms of ‘swelling of the lip’ or ‘swelling of the tongue or throat’ should not be documented as angioedema unless there is visible skin or mucosal swelling.
IAO_0000119: Vaccine 28 (2010) 4487-4498

generalized pruritus with skin rash finding
type: Class
subclass of: generalized pruritus finding
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000219
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
disjoint with: major cardiovascular criterion for anaphylaxis according to Brighton
disjoint with: major respiratory criterion for anaphylaxis according to Brighton
disjoint with: measured hypotension finding
disjoint with: capillary refill time > 3s finding
disjoint with: reduced central pulse volume finding
disjoint with: increased use of accessory respiratory muscles finding
disjoint with: recession finding
disjoint with: grunting finding
disjoint with: respiratory distress sign finding
disjoint with: red and itchy eyes finding
disjoint with: reduced peripheral circulation finding
disjoint with: reduced peripheral circulation diagnosis
disjoint with: generalized pruritus without skin rash finding
disjoint with: hoarse voice finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: nausea finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: minor dermatological criterion for anaphylaxis according to Brighton
disjoint with: minor cardiovascular criterion for anaphylaxis according to Brighton
disjoint with: minor respiratory criteria set for anaphylaxis according to Brighton
disjoint with: minor gastrointestinal criterion for anaphylaxis according to Brighton
disjoint with: minor laboratory criteria set for anaphylaxis according to Brighton
disjoint with: respiratory sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: indrawing finding
disjoint with: rhinorrhea finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: itchy eyes finding
disjoint with: prickle sensation finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding

_anaphylaxis according to Brighton criteria set of clinical findings
type: Class
subclass of: OGMS_0000014
comment: 20120821, MC: placeholder for development
IAO_0000115: the set of clinical findings that are classified as being relevant for the anaphylaxis diagnosis

major cardiovascular criterion for anaphylaxis according to Brighton
type: Class
subclass of: _anaphylaxis according to Brighton criteria set of clinical findings
subclass of: Restriction
  on property: involves
  some values from: UBERON_0004535
disjoint with: grunting finding
disjoint with: diarrhoea finding
disjoint with: dry cough finding
disjoint with: erythema finding
disjoint with: difficulty breathing finding
disjoint union of: clinical diagnosis of uncompensated shock
disjoint union of: measured hypotension finding

major respiratory criterion for anaphylaxis according to Brighton
type: Class
subclass of: _anaphylaxis according to Brighton criteria set of clinical findings
disjoint with: diarrhoea finding
disjoint with: dry cough finding
disjoint with: erythema finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
disjoint union of: respiratory distress diagnosis
disjoint union of: bilateral wheeze finding
disjoint union of: stridor finding
disjoint union of: upper airway swelling finding

measured hypotension finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0004535
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000037
disjoint with: capillary refill time > 3s finding
disjoint with: grunting finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
PHAC definition: An abnormally low blood pressure and documented by appropriate measurement. Infants and children: age specific systolic BP of <3-5%percentile or greater than a 30% decrease from that person’s baseline; Adults: systolic BP of <90mm Hg or greater than 30% decrease from that person’s baseline.
BrightonFormula: HypotensMeas
IAO_0000119: Vaccine 28 (2010) 4487-4498

uncompensated shock sign finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0004535
disjoint with: increased use of accessory respiratory muscles finding
disjoint with: cyanosis finding
disjoint with: grunting finding
disjoint with: hoarse voice finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: itchy eyes finding
disjoint with: pruritus finding
disjoint with: difficulty breathing finding
disjoint union of: tachycardia finding
disjoint union of: capillary refill time > 3s finding
disjoint union of: reduced central pulse volume finding
disjoint union of: decreased level of consciousness or loss of consciousness finding

tachycardia finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0004535
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000044
disjoint with: capillary refill time > 3s finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
PHAC definition: A heart rate that is abnormally high for age and circumstance (In beats per minute: <1year old: >160; 1 – 2 yrs: >150; 2-5 yrs: >140; 5-12 yrs: >120; >12 yrs: >100)
IAO_0000119: Citation for norms is Don & Roberton; Physical examination; in Practical Pediatrics 2007; 6th ed
BrightonFormula: TachyCard
IAO_0000119: Vaccine 28 (2010) 4487-4498

capillary refill time > 3s finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0004535
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000021
disjoint with: reduced central pulse volume finding
disjoint with: stridor finding
disjoint with: upper airway swelling finding
disjoint with: tachypnoea finding
disjoint with: increased use of accessory respiratory muscles finding
disjoint with: recession finding
disjoint with: cyanosis finding
disjoint with: grunting finding
disjoint with: respiratory distress sign finding
disjoint with: red and itchy eyes finding
disjoint with: generalized pruritus without skin rash finding
disjoint with: hoarse voice finding
disjoint with: sensation of throat closure finding
disjoint with: sneezing or rhinorrhea finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: nausea finding
disjoint with: vomiting finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: respiratory sign
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: indrawing finding
disjoint with: rhinorrhea finding
disjoint with: sore throat finding
disjoint with: wheezing finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: itchy eyes finding
disjoint with: prickle sensation finding
disjoint with: pruritus finding
disjoint with: rash finding
disjoint with: urticaria finding
disjoint with: decreased level of consciousness finding
disjoint with: sneezing finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075
BrightonFormula: CapRefillOver3
PHAC definition: Capillary refill time is the time required for the normal skin colour to reappear after a blanching pressure is applied. It is usually performed by pressing on the nail bed to cause blanching and then counting the time it takes for the blood to return to the tissue, indicated by a pink colour returning to the nail. Normally it is <3 seconds.
IAO_0000119: Vaccine 28 (2010) 4487-4498

reduced central pulse volume finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0004535
disjoint with: cyanosis finding
disjoint with: grunting finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
BrightonFormula: PulseVolRed

decreased level of consciousness or loss of consciousness finding
type: Class
equivalent class: Class
  union of: loss of consciousness finding
  union of: decreased level of consciousness finding
subclass of: Restriction
  on property: involves
  some values from: UBERON_0004535
comment: loss of counsciousness is a subclass of decreased consciousness, so saying "is about some decreased level of consciousness" I cover all cases

bilateral wheeze finding
type: Class
subclass of: wheezing finding
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000114
BrightonFormula: WheezeBilat
IAO_0000118: bronchospasm finding

stridor finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000042
disjoint with: cyanosis finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
PHAC definition: A harsh and continuous sound made on breathing in.
BrightonFormula: Stridor
IAO_0000119: Vaccine 28 (2010) 4487-4498

upper airway swelling finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000116
disjoint with: cyanosis finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
BrightonFormula: SwellUpAirways
IAO_0000232: lip, tongue, throat, uvula or larynx

tachypnoea finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000045
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
disjoint with: cyanosis finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
IAO_0000119: Citation for norms is Don & Roberton; Physical examination; in Practical Pediatrics 2007; 6th ed
PHAC definition: Rapid breathing which is abnormally high for age and circumstance rapid breathing whichis abnormally high for age and circumstance (<1yr: >60; 1-2 yrs: >40; 2-5 yrs: >35; 5-12 yrs: >30: >12 yrs: >16)
BrightonFormula: TachyPnea
IAO_0000119: Vaccine 28 (2010) 4487-4498
IAO_0000118: tachypnea finding

increased use of accessory respiratory muscles finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000031
disjoint with: grunting finding
disjoint with: red and itchy eyes finding
disjoint with: reduced peripheral circulation finding
disjoint with: reduced peripheral circulation diagnosis
disjoint with: sneezing or rhinorrhea finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
BrightonFormula: RespMuscAccIncr
IAO_0000232: sternocleidomastoid, intercostals, etc

recession finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000355
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
disjoint with: grunting finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
BrightonFormula: Recess

cyanosis finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000023
disjoint with: reduced peripheral circulation finding
disjoint with: sensation of throat closure finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: vomiting finding
disjoint with: minor cardiovascular criterion for anaphylaxis according to Brighton
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: rhinorrhea finding
disjoint with: sore throat finding
disjoint with: wheezing finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: pruritus finding
disjoint with: urticaria finding
disjoint with: sneezing finding
disjoint with: difficulty breathing finding
PHAC definition: A dark bluish or purplish discolouration of the skin and mucous membrane due to lack of oxygen in the blood.
BrightonFormula: Cyanosis
IAO_0000119: Vaccine 28 (2010) 4487-4498

grunting finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000029
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
disjoint with: red and itchy eyes finding
disjoint with: reduced peripheral circulation finding
disjoint with: reduced peripheral circulation diagnosis
disjoint with: hoarse voice finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: nausea finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: minor dermatological criterion for anaphylaxis according to Brighton
disjoint with: minor cardiovascular criterion for anaphylaxis according to Brighton
disjoint with: minor respiratory criteria set for anaphylaxis according to Brighton
disjoint with: minor gastrointestinal criterion for anaphylaxis according to Brighton
disjoint with: minor laboratory criteria set for anaphylaxis according to Brighton
disjoint with: cardiovascular sign
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: indrawing finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: itchy eyes finding
disjoint with: prickle sensation finding
disjoint with: pruritus finding
disjoint with: rash finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075
PHAC definition: A sudden and short noise with each breath when breathing out.
BrightonFormula: Grunting
IAO_0000119: Vaccine 28 (2010) 4487-4498

respiratory distress sign finding
type: Class
subclass of: OGMS_0000014
disjoint with: hoarse voice finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: itchy eyes finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
disjoint union of: tachypnoea finding
disjoint union of: increased use of accessory respiratory muscles finding
disjoint union of: recession finding
disjoint union of: cyanosis finding
disjoint union of: grunting finding

Brighton diagnosis of anaphylaxis as an adverse event following immunization
type: Class
subclass of: Brighton diagnosis result

Level 1 of certainty of anaphylaxis according to Brighton
type: Class
equivalent class: Class
  intersection of: Restriction
    on property: has component
    some values from: major dermatological criterion for anaphylaxis according to Brighton
  intersection of: Restriction
    on property: has component
    some values from: Class
      union of: major cardiovascular criterion for anaphylaxis according to Brighton
      union of: major respiratory criterion for anaphylaxis according to Brighton
subclass of: Brighton diagnosis of anaphylaxis as an adverse event following immunization

patient
type: Class
subclass of: MaterialEntity

generalized prickle sensation finding
type: Class
subclass of: prickle sensation finding
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000271
BrightonFormula: PrickleSens

localized injection site urticaria finding
type: Class
subclass of: urticaria finding
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000383
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
PHAC definition: Localized redness of superficial layers of skin that is itchy, raised, sharply demarcated and transient (that is skin changes at any location are usually present for less than 12 hours).
BrightonFormula: UrticariaLOC
IAO_0000119: Vaccine 28 (2010) 4487-4498

red and itchy eyes finding
type: Class
subclass of: OGMS_0000014
disjoint with: hoarse voice finding
disjoint with: diarrhoea finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
BrightonFormula: EyeRedItch

reduced peripheral circulation finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0004535
disjoint with: hoarse voice finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: itchy eyes finding
disjoint with: pruritus finding
disjoint with: difficulty breathing finding
disjoint union of: tachycardia finding
disjoint union of: decreased level of consciousness or loss of consciousness finding
disjoint union of: capillary refill time > 3s finding without hypotension

capillary refill time > 3s finding without hypotension
type: Class
subclass of: capillary refill time > 3s finding
subclass of: Restriction
  on property: involves
  some values from: UBERON_0004535

reduced peripheral circulation diagnosis
type: Class
equivalent class: minor cardiovascular criterion for anaphylaxis according to Brighton
equivalent class: Class
  intersection of: Restriction
    on property: has component
    on class: reduced peripheral circulation finding
    min qualified cardinality: 2
  intersection of: Restriction
    on property: has component
    on class: tachycardia finding
    max qualified cardinality: 1
  intersection of: Restriction
    on property: has component
    on class: decreased level of consciousness or loss of consciousness finding
    max qualified cardinality: 1
  intersection of: Restriction
    on property: has component
    on class: capillary refill time > 3s finding without hypotension
    max qualified cardinality: 1
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0004535
disjoint with: hoarse voice finding
disjoint with: diarrhoea finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: itchy eyes finding
disjoint with: pruritus finding
disjoint with: difficulty breathing finding
comment: The reduced peripheral circulation diagnosis is the minor cardiovascular criterion for anaphylaxis according to Brighton. The diagnosis is established by observing the combination of at least 2 reduced peripheral circulation findings, but at most one of each type.

generalized pruritus without skin rash finding
type: Class
subclass of: generalized pruritus finding
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000220
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding

persistent dry cough finding
type: Class
subclass of: dry cough finding
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000027
BrightonFormula: CoughPersisDry
PHAC definition: Rapid expulsion of air from the lungs to clear the lung airways and not accompanied by expectoration (a non-productive cough).
IAO_0000119: Vaccine 28 (2010) 4487-4498

hoarse voice finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000030
disjoint with: sneezing or rhinorrhea finding
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: cardiovascular sign
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
PHAC definition: An unnaturally harsh cry of infant or vocalization in a child or adult.
IAO_0000119: Vaccine 28 (2010) 4487-4498
BrightonFormula: VoiceHoarse

sensation of throat closure finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
disjoint with: diarrhoea finding
disjoint with: abdominal pain finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
BrightonFormula: ThroatCloseSens

sneezing or rhinorrhea finding
type: Class
equivalent class: Class
  union of: rhinorrhea finding
  union of: sneezing finding
subclass of: OGMS_0000014
disjoint with: diarrhoea finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: itchy eyes finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding

diarrhoea finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000026
subclass of: Restriction
  on property: involves
  some values from: UBERON_0005409
disjoint with: abdominal pain finding
disjoint with: nausea finding
disjoint with: vomiting finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: minor dermatological criterion for anaphylaxis according to Brighton
disjoint with: minor cardiovascular criterion for anaphylaxis according to Brighton
disjoint with: minor respiratory criteria set for anaphylaxis according to Brighton
disjoint with: minor laboratory criteria set for anaphylaxis according to Brighton
disjoint with: respiratory sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: indrawing finding
disjoint with: rhinorrhea finding
disjoint with: sore throat finding
disjoint with: wheezing finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: itchy eyes finding
disjoint with: prickle sensation finding
disjoint with: pruritus finding
disjoint with: rash finding
disjoint with: urticaria finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075
BrightonFormula: Diarrhea
PHAC definition: Loose and/or watery stool which may occur more frequently than usual.
IAO_0000119: Vaccine 28 (2010) 4487-4498
IAO_0000118: diarrhea finding

abdominal pain finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0005409
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000020
disjoint with: nausea finding
disjoint with: vomiting finding
disjoint with: mast cell tryptase elevation > upper normal limit finding
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: indrawing finding
disjoint with: rhinorrhea finding
disjoint with: sore throat finding
disjoint with: wheezing finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: itchy eyes finding
disjoint with: prickle sensation finding
disjoint with: pruritus finding
disjoint with: rash finding
disjoint with: urticaria finding
disjoint with: decreased level of consciousness finding
disjoint with: sneezing finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075
BrightonFormula: AbdoPain
PHAC definition: Sensation of discomfort or pain in the abdominal region.
IAO_0000119: Vaccine 28 (2010) 4487-4498

nausea finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0005409
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000038
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
PHAC definition: An unpleasant sensation vaguely referred to the upper abdominal region and the abdomen, with a tendency to vomit.
BrightonFormula: Nausea

vomiting finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000046
subclass of: Restriction
  on property: involves
  some values from: UBERON_0005409
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: urticaria finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
PHAC definition: The reflex act of ejecting the contents of the stomach through the mouth.
IAO_0000119: Vaccine 28 (2010) 4487-4498
BrightonFormula: VomitUnspec

mast cell tryptase elevation > upper normal limit finding
type: Class
subclass of: OGMS_0000014
disjoint with: minor respiratory criteria set for anaphylaxis according to Brighton
disjoint with: cardiovascular sign
disjoint with: respiratory sign
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
BrightonFormula: MastCellTryp

minor dermatological criterion for anaphylaxis according to Brighton
type: Class
subclass of: _anaphylaxis according to Brighton criteria set of clinical findings
disjoint with: dry cough finding
disjoint with: erythema finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
disjoint union of: generalized prickle sensation finding
disjoint union of: localized injection site urticaria finding
disjoint union of: red and itchy eyes finding
disjoint union of: generalized pruritus without skin rash finding

minor cardiovascular criterion for anaphylaxis according to Brighton
type: Class
subclass of: _anaphylaxis according to Brighton criteria set of clinical findings
disjoint with: dry cough finding
disjoint with: erythema finding
disjoint with: difficulty breathing finding

minor respiratory criteria set for anaphylaxis according to Brighton
type: Class
subclass of: _anaphylaxis according to Brighton criteria set of clinical findings
disjoint with: erythema finding
disjoint with: decreased level of consciousness finding
disjoint union of: persistent dry cough finding
disjoint union of: hoarse voice finding
disjoint union of: sensation of throat closure finding
disjoint union of: sneezing or rhinorrhea finding
disjoint union of: difficulty breathing without wheeze or stridor finding

difficulty breathing without wheeze or stridor finding
type: Class
subclass of: difficulty breathing finding
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000288
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
IAO_0000232: 20130319, MC: Here the ontology is more specific than Brighton formula which just states "DiffBreath" - we logically encode the restrictions mentioned in the guideline -> without wheeze or stridor
BrightonFormula: DiffBreath

minor gastrointestinal criterion for anaphylaxis according to Brighton
type: Class
subclass of: _anaphylaxis according to Brighton criteria set of clinical findings
disjoint with: dry cough finding
disjoint with: erythema finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
disjoint union of: diarrhoea finding
disjoint union of: abdominal pain finding
disjoint union of: nausea finding
disjoint union of: vomiting finding

minor laboratory criteria set for anaphylaxis according to Brighton
type: Class
subclass of: _anaphylaxis according to Brighton criteria set of clinical findings
disjoint with: dry cough finding
disjoint with: erythema finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding

Level 2 of certainty of anaphylaxis according to Brighton
type: Class
equivalent class: Class
  union of: Class
    intersection of: Class
      union of: Restriction
        on property: has component
        some values from: major cardiovascular criterion for anaphylaxis according to Brighton
      union of: Restriction
        on property: has component
        some values from: major respiratory criterion for anaphylaxis according to Brighton
    intersection of: Class
      union of: Restriction
        on property: has component
        some values from: minor dermatological criterion for anaphylaxis according to Brighton
      union of: Restriction
        on property: has component
        some values from: minor gastrointestinal criterion for anaphylaxis according to Brighton
      union of: Restriction
        on property: has component
        some values from: minor laboratory criteria set for anaphylaxis according to Brighton
  union of: Class
    intersection of: Class
      union of: Restriction
        on property: has component
        some values from: minor cardiovascular criterion for anaphylaxis according to Brighton
      union of: Restriction
        on property: has component
        some values from: minor respiratory criteria set for anaphylaxis according to Brighton
    intersection of: Restriction
      on property: has component
      some values from: major dermatological criterion for anaphylaxis according to Brighton
  union of: Class
    intersection of: Restriction
      on property: has component
      some values from: major cardiovascular criterion for anaphylaxis according to Brighton
    intersection of: Restriction
      on property: has component
      some values from: major respiratory criterion for anaphylaxis according to Brighton
subclass of: Brighton diagnosis of anaphylaxis as an adverse event following immunization

Level 3 of certainty of anaphylaxis according to Brighton
type: Class
equivalent class: Class
  intersection of: Class
    union of: Class
      intersection of: Restriction
        on property: has component
        some values from: minor dermatological criterion for anaphylaxis according to Brighton
      intersection of: Restriction
        on property: has component
        some values from: minor gastrointestinal criterion for anaphylaxis according to Brighton
    union of: Class
      intersection of: Restriction
        on property: has component
        some values from: minor dermatological criterion for anaphylaxis according to Brighton
      intersection of: Restriction
        on property: has component
        some values from: minor laboratory criteria set for anaphylaxis according to Brighton
    union of: Class
      intersection of: Restriction
        on property: has component
        some values from: minor gastrointestinal criterion for anaphylaxis according to Brighton
      intersection of: Restriction
        on property: has component
        some values from: minor laboratory criteria set for anaphylaxis according to Brighton
  intersection of: Class
    union of: Restriction
      on property: has component
      some values from: minor cardiovascular criterion for anaphylaxis according to Brighton
    union of: Restriction
      on property: has component
      some values from: minor respiratory criteria set for anaphylaxis according to Brighton
subclass of: Brighton diagnosis of anaphylaxis as an adverse event following immunization

cardiovascular sign
type: Class
equivalent class: Class
  intersection of: OGMS_0000014
  intersection of: Restriction
    on property: involves
    some values from: UBERON_0004535
disjoint with: gastrointestinal sign
disjoint with: dry cough finding
disjoint with: erythema finding
disjoint with: itchy eyes finding
disjoint with: pruritus finding
disjoint with: difficulty breathing finding

respiratory sign
type: Class
equivalent class: Class
  intersection of: OGMS_0000014
  intersection of: Restriction
    on property: involves
    some values from: UBERON_0001004
disjoint with: gastrointestinal sign
disjoint with: erythema finding
disjoint with: itchy eyes finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding

gastrointestinal sign
type: Class
equivalent class: Class
  intersection of: OGMS_0000014
  intersection of: Restriction
    on property: involves
    some values from: UBERON_0005409
disjoint with: dry cough finding
disjoint with: chest tightness finding
disjoint with: indrawing finding
disjoint with: rhinorrhea finding
disjoint with: sore throat finding
disjoint with: wheezing finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: itchy eyes finding
disjoint with: prickle sensation finding
disjoint with: pruritus finding
disjoint with: rash finding
disjoint with: urticaria finding
disjoint with: decreased level of consciousness finding
disjoint with: sneezing finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075

Reported anaphylaxis with insufficient evidence to meet the case definition
type: Class
equivalent class: Class
  intersection of: reported anaphylaxis
  intersection of: Class
    complement of: Level 1 of certainty of anaphylaxis according to Brighton
  intersection of: Class
    complement of: Level 2 of certainty of anaphylaxis according to Brighton
  intersection of: Class
    complement of: Level 3 of certainty of anaphylaxis according to Brighton
  intersection of: Class
    complement of: not a case of anaphylaxis
subclass of: reported anaphylaxis

not a case of anaphylaxis
type: Class
subclass of: Brighton diagnosis of anaphylaxis as an adverse event following immunization

dry cough finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
disjoint with: chest tightness finding
disjoint with: indrawing finding
disjoint with: sore throat finding
disjoint with: wheezing finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: itchy eyes finding
disjoint with: prickle sensation finding
disjoint with: pruritus finding
disjoint with: rash finding
disjoint with: urticaria finding
disjoint with: decreased level of consciousness finding
disjoint with: sneezing finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075

chest tightness finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000022
disjoint with: indrawing finding
disjoint with: rhinorrhea finding
disjoint with: sore throat finding
disjoint with: wheezing finding
disjoint with: erythema finding
disjoint with: red eyes finding
disjoint with: itchy eyes finding
disjoint with: prickle sensation finding
disjoint with: pruritus finding
disjoint with: rash finding
disjoint with: urticaria finding
disjoint with: decreased level of consciousness finding
disjoint with: sneezing finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075

indrawing finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000032
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding

rhinorrhea finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000354
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
PHAC definition: Discharge of thin nasal mucus.
BrightonFormula: Rhinorrhea

sore throat finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000040
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding

wheezing finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000048
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
disjoint with: erythema finding
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding

erythema finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000205
disjoint with: red eyes finding
disjoint with: itchy eyes finding
disjoint with: prickle sensation finding
disjoint with: pruritus finding
disjoint with: rash finding
disjoint with: urticaria finding
disjoint with: decreased level of consciousness finding
disjoint with: sneezing finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075

generalized erythema finding
type: Class
subclass of: erythema finding
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000104
BrightonFormula: ErythemaGen

red eyes finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000338
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding

itchy eyes finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000339
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding

prickle sensation finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000336
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
disjoint with: pruritus finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
PHAC definition: Tingling or smarting (stinging) sensation.

pruritus finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000335
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
disjoint with: rash finding
disjoint with: urticaria finding
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075

generalized pruritus finding
type: Class
equivalent class: Class
  union of: generalized pruritus with skin rash finding
  union of: generalized pruritus without skin rash finding
subclass of: pruritus finding
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000107
BrightonFormula: PruritusGen

rash finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000337
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding

skin rash finding
type: Class
subclass of: rash finding
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000108
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
BrightonFormula: SkinRash

urticaria finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000334
disjoint with: decreased level of consciousness finding
disjoint with: difficulty breathing finding

generalized urticaria finding
type: Class
subclass of: urticaria finding
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000103
subclass of: Restriction
  on property: involves
  some values from: UBERON_0012125
BrightonFormula: UrticariaGen
IAO_0000118: hives finding

decreased level of consciousness finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000024
subclass of: Restriction
  on property: involves
  some values from: UBERON_0004535
disjoint with: sneezing finding
disjoint with: difficulty breathing finding
disjoint with: OBI_0000075
BrightonFormula: ConscDecr
PHAC definition: Reduced alertness or awareness of the outside world.

tonic-clonic manifestation finding
type: Class
subclass of: motor manifestation
subclass of: Restriction
  on property: has component
  some values from: Class
    intersection of: clonic motor manifestation finding
    intersection of: Restriction
      on property: preceded by
      all values from: tonic motor manifestation finding
IAO_0000115: A sequence consisting of a tonic followed by a clonic phase

sneezing finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: IAO_0000136
  some values from: OMRE_0000291
disjoint with: difficulty breathing finding
PHAC definition: An involuntary (reflex), sudden, violent, and audible expulsion of air through the mouth and nose.
BrightonFormula: Sneeze
IAO_0000119: Vaccine 28 (2010) 4487-4498

difficulty breathing finding
type: Class
subclass of: OGMS_0000014
subclass of: Restriction
  on property: involves
  some values from: UBERON_0001004
disjoint with: OBI_0000075

reported anaphylaxis
type: Class
subclass of: Brighton diagnosis of anaphylaxis as an adverse event following immunization

Level 3 of certainty of anaphylaxis - post ICPE
type: Class
equivalent class: Class
  union of: Class
    intersection of: Class
      union of: Class
        intersection of: Restriction
      union of: Class
        intersection of: Restriction
      union of: Class
        intersection of: Restriction
    intersection of: Restriction
      on property: has component
      some values from: minor respiratory criteria set for anaphylaxis according to Brighton - post ICPE
  union of: Class
    intersection of: Class
      union of: Class
        intersection of: Restriction
      union of: Class
        intersection of: Restriction
      union of: Class
        intersection of: Restriction
    intersection of: Restriction
      on property: has component
      some values from: minor cardiovascular criterion for anaphylaxis according to Brighton
subclass of: Brighton diagnosis of anaphylaxis as an adverse event following immunization
comment: Following the ICPE meeting in Montreal 2013, MC clarified with JB that the guideline should be understood as "if there is a minor cardiovascular criteria, then we need 2 other systems involved, including respiratory, dermatologic, gastrointestinal and laboratory" and similarly if there is a respiratory criteria. The first iteration was interpreted as (1 minor cardiovascular OR respiratory criterion) AND 2 minors from systems that are neither respiratory nor cardiovascular (dermatologic, gastrointestinal , laboratory systems) to mimic behavior of the ABC tool.

minor respiratory criteria set for anaphylaxis according to Brighton - post ICPE
type: Class
subclass of: _anaphylaxis according to Brighton criteria set of clinical findings
comment: Following meeting at ICPE Montreal 2013, MC and JB clairfied that "difficulty breathing without wheeze or stridor" should be understood as "difficulty breathing"
disjoint union of: persistent dry cough finding
disjoint union of: hoarse voice finding
disjoint union of: sensation of throat closure finding
disjoint union of: sneezing or rhinorrhea finding
disjoint union of: difficulty breathing finding

minor dermatological criterion for anaphylaxis according to Brighton - post ICPE
type: Class
subclass of: _anaphylaxis according to Brighton criteria set of clinical findings
comment: Following meeting at ICPE Montreal 2013, MC and JB clairfied that "genralized pruritus withou rash" should be understood as "generalized pruritus"
disjoint union of: generalized prickle sensation finding
disjoint union of: localized injection site urticaria finding
disjoint union of: red and itchy eyes finding
disjoint union of: generalized pruritus finding

Level 2 of certainty of anaphylaxis according to Brighton - post ICPE
type: Class
equivalent class: Class
  union of: Class
    intersection of: Class
      union of: Restriction
        on property: has component
        some values from: major cardiovascular criterion for anaphylaxis according to Brighton
      union of: Restriction
        on property: has component
        some values from: major respiratory criterion for anaphylaxis according to Brighton
    intersection of: Class
      union of: Restriction
        on property: has component
        some values from: minor gastrointestinal criterion for anaphylaxis according to Brighton
      union of: Restriction
        on property: has component
        some values from: minor laboratory criteria set for anaphylaxis according to Brighton
      union of: Restriction
        on property: has component
        some values from: minor dermatological criterion for anaphylaxis according to Brighton - post ICPE
  union of: Class
    intersection of: Class
      union of: Restriction
        on property: has component
        some values from: minor cardiovascular criterion for anaphylaxis according to Brighton
      union of: Restriction
        on property: has component
        some values from: minor respiratory criteria set for anaphylaxis according to Brighton - post ICPE
    intersection of: Restriction
      on property: has component
      some values from: major dermatological criterion for anaphylaxis according to Brighton
  union of: Class
    intersection of: Restriction
      on property: has component
      some values from: major cardiovascular criterion for anaphylaxis according to Brighton
    intersection of: Restriction
      on property: has component
      some values from: major respiratory criterion for anaphylaxis according to Brighton
subclass of: Brighton diagnosis of anaphylaxis as an adverse event following immunization

Level 3 of certainty of anaphylaxis - PHAC form
type: Class
equivalent class: Class
  intersection of: Class
    union of: Class
      intersection of: Restriction
        on property: has component
        some values from: minor gastrointestinal criterion for anaphylaxis according to Brighton
      intersection of: Restriction
        on property: has component
        some values from: minor laboratory criteria set for anaphylaxis according to Brighton
    union of: Class
      intersection of: Restriction
        on property: has component
        some values from: minor gastrointestinal criterion for anaphylaxis according to Brighton
      intersection of: Restriction
        on property: has component
        some values from: Class
    union of: Class
      intersection of: Restriction
        on property: has component
        some values from: minor laboratory criteria set for anaphylaxis according to Brighton
      intersection of: Restriction
        on property: has component
        some values from: Class
  intersection of: Class
    union of: Restriction
      on property: has component
      some values from: minor cardiovascular criterion for anaphylaxis according to Brighton
    union of: Restriction
      on property: has component
      some values from: minor respiratory criteria set for anaphylaxis according to Brighton
subclass of: Brighton diagnosis of anaphylaxis as an adverse event following immunization
comment: 20130912: In the paper http://dx.doi.org/10.1016/j.vaccine.2010.04.041 "Can the Brighton Collaboration case definitions be used to improve the quality of Adverse Event Following Immunization (AEFI) reporting? Anaphylaxis as a case study", the form used by PHAC and shown in Appendix E states as a footnote "for level III, a skin MAJOR can count as a minor criterion"

cynosis-token
type: NamedIndividual
type: respiratory-distress-token

grunting-token
type: NamedIndividual
type: respiratory-distress-token

increased use of accessory respiratory muscles-token
type: NamedIndividual
type: respiratory-distress-token

recession-token
type: NamedIndividual
type: respiratory-distress-token

tachypnoea-token
type: NamedIndividual
type: respiratory-distress-token

tachycardia-token
type: NamedIndividual
type: uncompensated-shock-token

capillary refill time above 3s-token
type: NamedIndividual
type: uncompensated-shock-token

reduced central pulse volume-token
type: NamedIndividual
type: uncompensated-shock-token

decreased level of consciousness or loss of consciousness-token
type: NamedIndividual
type: uncompensated-shock-token

AERO_0000352
PHAC definition: An acute hypersensitivity reaction with multi-organ-system involvement that can present as, or rapidly progress to, a severe life-threatening reaction.