Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot - ballot International flag

Evidence Based Medicine on FHIR Implementation Guide, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/ebm/ and changes regularly. See the Directory of published versions

Resource Profile: CertaintyOfEvidence - Detailed Descriptions

Page standards status: Draft Maturity Level: 1

Definitions for the certainty-of-evidence resource profile.

Guidance on how to interpret the contents of this table can be found here

0. ArtifactAssessment
2. ArtifactAssessment.extension
SlicingThis element introduces a set of slices on ArtifactAssessment.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. ArtifactAssessment.extension:url
    Slice Nameurl
    Control0..1
    TypeExtension(Artifact URL) (Extension Type: uri)
    6. ArtifactAssessment.extension:description
    Slice Namedescription
    Control0..1
    TypeExtension(Artifact Description) (Extension Type: markdown)
    8. ArtifactAssessment.extension:author
    Slice Nameauthor
    Control0..*
    TypeExtension(Artifact Author) (Extension Type: ContactDetail)
    10. ArtifactAssessment.identifier
    Definition

    A formal identifier that is used to identify this CertaintyOfEvidence when it is represented in other formats, or referenced in a specification, model, design or an instance.

    ShortAdditional identifier for the CertaintyOfEvidence
    Comments

    Typically, this is used for identifiers that can be used in systems outside of FHIR, where it is not sufficient to use the logical URI.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Requirements

    Allows externally provided and/or usable business identifiers to be easily associated with the CertaintyOfEvidence.

    12. ArtifactAssessment.citeAs[x]
    Definition

    Display of or reference to the bibliographic citation of the CertaintyOfEvidence.

    ShortHow to cite the CertaintyOfEvidence
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    14. ArtifactAssessment.date
    Definition

    The date (and optionally time) when the CertaintyOfEvidence was published. The date should change when the substantive content of the CertaintyOfEvidence changes.

    16. ArtifactAssessment.copyright
    Definition

    A copyright statement relating to the CertaintyOfEvidence and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the CertaintyOfEvidence.

    Requirements

    Consumers must be able to determine any legal restrictions on the use of the CertaintyOfEvidence and/or its content.

    18. ArtifactAssessment.approvalDate
    ShortWhen the CertaintyOfEvidence was approved by publisher
    20. ArtifactAssessment.lastReviewDate
    ShortWhen the CertaintyOfEvidence was last reviewed
    22. ArtifactAssessment.artifact[x]
    Definition

    A reference to a resource, canonical resource, or non-FHIR resource which the CertaintyOfEvidence is about.

    ShortThe artifact that is rated
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    24. ArtifactAssessment.content
    Definition

    A rating or classification of the artifact.

    ShortA rating
    26. ArtifactAssessment.content.informationType
    Comments

    The code 'rating' will be the value in most instances. Other codes may be used for complex CertaintyOfEvidence with content.component use.

    28. ArtifactAssessment.content.type
    BindingUnless not suitable, these codes SHALL be taken from EvidenceCertaintyType
    (extensible to http://hl7.org/fhir/ValueSet/certainty-type)
    30. ArtifactAssessment.content.classifier
    BindingUnless not suitable, these codes SHALL be taken from EvidenceCertaintyRating
    (extensible to http://hl7.org/fhir/ValueSet/certainty-rating)
    32. ArtifactAssessment.content.freeToShare
    Definition

    Acceptable to publicly share the CertaintyOfEvidence content, specific to the associated content instance

    ShortAcceptable to publicly share the CertaintyOfEvidence content

    Guidance on how to interpret the contents of this table can be found here

    0. ArtifactAssessment
    Definition

    This Resource provides one or more comments, classifiers or ratings about a Resource and supports attribution and rights management metadata for the added content.

    ShortAdds metadata-supported comments, classifiers or ratings related to a Resource
    Control0..*
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    2. ArtifactAssessment.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    ShortA set of rules under which this content was created
    Comments

    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. ArtifactAssessment.contained
    Definition

    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

    ShortContained, inline Resources
    Comments

    This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

    Control0..*
    This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
    TypeResource
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Alternate Namesinline resources, anonymous resources, contained resources
    6. ArtifactAssessment.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on ArtifactAssessment.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 8. ArtifactAssessment.extension:url
      Slice Nameurl
      Definition

      An absolute URI that is used to identify this {{title}} when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this {{title}} is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the {{title}} is stored on different servers.

      ShortCanonical identifier for this {{title}}, represented as a URI (globally unique)
      Comments

      Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

      The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

      In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

      Control0..1
      TypeExtension(Artifact URL) (Extension Type: uri)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. ArtifactAssessment.extension:description
      Slice Namedescription
      Definition

      A free text natural language description of the {{title}} from a consumer's perspective.

      ShortNatural language description of the {{title}}
      Comments

      This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the {{title}} as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the {{title}} is presumed to be the predominant language in the place the {{title}} was created).

      Control0..1
      TypeExtension(Artifact Description) (Extension Type: markdown)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      12. ArtifactAssessment.extension:author
      Slice Nameauthor
      Definition

      An individiual or organization primarily involved in the creation and maintenance of the {{title}}.

      ShortWho authored the {{title}}
      Control0..*
      TypeExtension(Artifact Author) (Extension Type: ContactDetail)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      14. ArtifactAssessment.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Must Supportfalse
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      16. ArtifactAssessment.identifier
      Definition

      A formal identifier that is used to identify this CertaintyOfEvidence when it is represented in other formats, or referenced in a specification, model, design or an instance.


      A formal identifier that is used to identify this artifact assessment when it is represented in other formats, or referenced in a specification, model, design or an instance.

      ShortAdditional identifier for the CertaintyOfEvidenceAdditional identifier for the artifact assessment
      Comments

      Typically, this is used for identifiers that can be used in systems outside of FHIR, where it is not sufficient to use the logical URI.


      Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this activity definition outside of FHIR, where it is not possible to use the logical URI.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

      Allows externally provided and/or usable business identifiers to be easily associated with the CertaintyOfEvidence.


      Allows externally provided and/or usable business identifiers to be easily associated with the artifact assessment.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. ArtifactAssessment.citeAs[x]
      Definition

      Display of or reference to the bibliographic citation of the CertaintyOfEvidence.


      Display of or reference to the bibliographic citation of the comment, classifier, or rating.

      ShortHow to cite the CertaintyOfEvidenceHow to cite the comment or rating
      Control0..1
      TypeChoice of: Reference(Citation), markdown
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. ArtifactAssessment.date
      Definition

      The date (and optionally time) when the CertaintyOfEvidence was published. The date should change when the substantive content of the CertaintyOfEvidence changes.


      The date (and optionally time) when the artifact assessment was published. The date must change when the disposition changes and it must change if the workflow status code changes. In addition, it should change when the substantive content of the artifact assessment changes.

      ShortDate last changed
      Comments

      The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the artifact assessment. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

      Control0..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Alternate NamesRevision Date
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. ArtifactAssessment.copyright
      Definition

      A copyright statement relating to the CertaintyOfEvidence and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the CertaintyOfEvidence.


      A copyright statement relating to the artifact assessment and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the artifact assessment.

      ShortUse and/or publishing restrictions
      Control0..1
      Typemarkdown
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Requirements

      Consumers must be able to determine any legal restrictions on the use of the CertaintyOfEvidence and/or its content.


      Consumers must be able to determine any legal restrictions on the use of the artifact assessment and/or its content.

      Alternate NamesLicense, Restrictions
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. ArtifactAssessment.approvalDate
      Definition

      The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

      ShortWhen the CertaintyOfEvidence was approved by publisherWhen the artifact assessment was approved by publisher
      Comments

      The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

      Control0..1
      Typedate
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. ArtifactAssessment.lastReviewDate
      Definition

      The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

      ShortWhen the CertaintyOfEvidence was last reviewedWhen the artifact assessment was last reviewed by the publisher
      Comments

      If specified, this date follows the original approval date.

      Control0..1
      Typedate
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Requirements

      Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. ArtifactAssessment.artifact[x]
      Definition

      A reference to a resource, canonical resource, or non-FHIR resource which the CertaintyOfEvidence is about.


      A reference to a resource, canonical resource, or non-FHIR resource which the comment or assessment is about.

      ShortThe artifact that is ratedThe artifact assessed, commented upon or rated
      Control1..1
      TypeChoice of: Reference(Resource), canonical, uri
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. ArtifactAssessment.content
      Definition

      A rating or classification of the artifact.


      A component comment, classifier, or rating of the artifact.

      ShortA ratingComment, classifier, or rating content
      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. ArtifactAssessment.content.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      34. ArtifactAssessment.content.informationType
      Definition

      The type of information this component of the content represents.

      Shortcomment | classifier | rating | container | response | change-request
      Comments

      The code 'rating' will be the value in most instances. Other codes may be used for complex CertaintyOfEvidence with content.component use.

      Control0..1
      BindingThe codes SHALL be taken from ArtifactAssessmentInformationTypehttp://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0
      (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. ArtifactAssessment.content.type
      Definition

      Indicates what type of content this component represents.

      ShortWhat type of content
      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see EvidenceCertaintyTypehttp://hl7.org/fhir/ValueSet/certainty-type
      (extensible to http://hl7.org/fhir/ValueSet/certainty-type)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. ArtifactAssessment.content.classifier
      Definition

      Represents a rating, classifier, or assessment of the artifact.

      ShortRating, classifier, or assessment
      Control0..*
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see EvidenceCertaintyRatinghttp://hl7.org/fhir/ValueSet/certainty-rating
      (extensible to http://hl7.org/fhir/ValueSet/certainty-rating)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. ArtifactAssessment.content.freeToShare
      Definition

      Acceptable to publicly share the CertaintyOfEvidence content, specific to the associated content instance


      Acceptable to publicly share the comment, classifier or rating.

      ShortAcceptable to publicly share the CertaintyOfEvidence contentAcceptable to publicly share the resource content
      Control0..1
      Typeboolean
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. ArtifactAssessment
      Definition

      This Resource provides one or more comments, classifiers or ratings about a Resource and supports attribution and rights management metadata for the added content.

      ShortAdds metadata-supported comments, classifiers or ratings related to a Resource
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. ArtifactAssessment.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

      Control0..1
      Typeid
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      4. ArtifactAssessment.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. ArtifactAssessment.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. ArtifactAssessment.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHALL be taken from AllLanguages
      (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

      IETF language tag for a human language

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. ArtifactAssessment.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      This element is affected by the following invariants: dom-6
      TypeNarrative
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. ArtifactAssessment.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

      Control0..*
      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
      TypeResource
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. ArtifactAssessment.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on ArtifactAssessment.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. ArtifactAssessment.extension:url
        Slice Nameurl
        Definition

        An absolute URI that is used to identify this {{title}} when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this {{title}} is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the {{title}} is stored on different servers.

        ShortCanonical identifier for this {{title}}, represented as a URI (globally unique)
        Comments

        Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

        The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

        In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

        Control0..1
        TypeExtension(Artifact URL) (Extension Type: uri)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. ArtifactAssessment.extension:description
        Slice Namedescription
        Definition

        A free text natural language description of the {{title}} from a consumer's perspective.

        ShortNatural language description of the {{title}}
        Comments

        This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the {{title}} as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the {{title}} is presumed to be the predominant language in the place the {{title}} was created).

        Control0..1
        TypeExtension(Artifact Description) (Extension Type: markdown)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. ArtifactAssessment.extension:author
        Slice Nameauthor
        Definition

        An individiual or organization primarily involved in the creation and maintenance of the {{title}}.

        ShortWho authored the {{title}}
        Control0..*
        TypeExtension(Artifact Author) (Extension Type: ContactDetail)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        22. ArtifactAssessment.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Must Supportfalse
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        24. ArtifactAssessment.identifier
        Definition

        A formal identifier that is used to identify this CertaintyOfEvidence when it is represented in other formats, or referenced in a specification, model, design or an instance.

        ShortAdditional identifier for the CertaintyOfEvidence
        Comments

        Typically, this is used for identifiers that can be used in systems outside of FHIR, where it is not sufficient to use the logical URI.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Requirements

        Allows externally provided and/or usable business identifiers to be easily associated with the CertaintyOfEvidence.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. ArtifactAssessment.title
        Definition

        A short title for the assessment for use in displaying and selecting.

        ShortA short title for the assessment for use in displaying and selecting
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. ArtifactAssessment.citeAs[x]
        Definition

        Display of or reference to the bibliographic citation of the CertaintyOfEvidence.

        ShortHow to cite the CertaintyOfEvidence
        Control0..1
        TypeChoice of: Reference(Citation), markdown
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. ArtifactAssessment.date
        Definition

        The date (and optionally time) when the CertaintyOfEvidence was published. The date should change when the substantive content of the CertaintyOfEvidence changes.

        ShortDate last changed
        Comments

        The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the artifact assessment. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

        Control0..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Alternate NamesRevision Date
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. ArtifactAssessment.copyright
        Definition

        A copyright statement relating to the CertaintyOfEvidence and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the CertaintyOfEvidence.

        ShortUse and/or publishing restrictions
        Control0..1
        Typemarkdown
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Requirements

        Consumers must be able to determine any legal restrictions on the use of the CertaintyOfEvidence and/or its content.

        Alternate NamesLicense, Restrictions
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. ArtifactAssessment.approvalDate
        Definition

        The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

        ShortWhen the CertaintyOfEvidence was approved by publisher
        Comments

        The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

        Control0..1
        Typedate
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. ArtifactAssessment.lastReviewDate
        Definition

        The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

        ShortWhen the CertaintyOfEvidence was last reviewed
        Comments

        If specified, this date follows the original approval date.

        Control0..1
        Typedate
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Requirements

        Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. ArtifactAssessment.artifact[x]
        Definition

        A reference to a resource, canonical resource, or non-FHIR resource which the CertaintyOfEvidence is about.

        ShortThe artifact that is rated
        Control1..1
        TypeChoice of: Reference(Resource), canonical, uri
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. ArtifactAssessment.content
        Definition

        A rating or classification of the artifact.

        ShortA rating
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. ArtifactAssessment.content.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        This element is affected by the following invariants: ele-1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        44. ArtifactAssessment.content.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        46. ArtifactAssessment.content.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        48. ArtifactAssessment.content.informationType
        Definition

        The type of information this component of the content represents.

        Shortcomment | classifier | rating | container | response | change-request
        Comments

        The code 'rating' will be the value in most instances. Other codes may be used for complex CertaintyOfEvidence with content.component use.

        Control0..1
        BindingThe codes SHALL be taken from ArtifactAssessmentInformationType
        (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. ArtifactAssessment.content.summary
        Definition

        A brief summary of the content of this component.

        ShortBrief summary of the content
        Control0..1
        Typemarkdown
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. ArtifactAssessment.content.type
        Definition

        Indicates what type of content this component represents.

        ShortWhat type of content
        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from EvidenceCertaintyType
        (extensible to http://hl7.org/fhir/ValueSet/certainty-type)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. ArtifactAssessment.content.classifier
        Definition

        Represents a rating, classifier, or assessment of the artifact.

        ShortRating, classifier, or assessment
        Control0..*
        BindingUnless not suitable, these codes SHALL be taken from EvidenceCertaintyRating
        (extensible to http://hl7.org/fhir/ValueSet/certainty-rating)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. ArtifactAssessment.content.quantity
        Definition

        A quantitative rating of the artifact.

        ShortQuantitative rating
        Control0..1
        TypeQuantity
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. ArtifactAssessment.content.author
        Definition

        Indicates who or what authored the content.

        ShortWho authored the content
        Control0..1
        TypeReference(Patient, Practitioner, PractitionerRole, Organization, Device)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. ArtifactAssessment.content.path
        Definition

        A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource.

        ShortWhat the comment is directed to
        Comments

        The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80).

        Control0..*
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. ArtifactAssessment.content.relatedArtifact
        Definition

        Additional related artifacts that provide supporting documentation, additional evidence, or further information related to the content.

        ShortAdditional information
        Control0..*
        TypeRelatedArtifact
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. ArtifactAssessment.content.freeToShare
        Definition

        Acceptable to publicly share the CertaintyOfEvidence content, specific to the associated content instance

        ShortAcceptable to publicly share the CertaintyOfEvidence content
        Control0..1
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. ArtifactAssessment.content.component
        Definition

        If the informationType is container, the components of the content.

        ShortContained content
        Control0..*
        TypeSee ttp://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. ArtifactAssessment.workflowStatus
        Definition

        Indicates the workflow status of the comment or change request.

        Shortsubmitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published | entered-in-error
        Control0..1
        BindingThe codes SHALL be taken from ArtifactAssessmentWorkflowStatus
        (required to http://hl7.org/fhir/ValueSet/artifactassessment-workflow-status|5.0.0)
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. ArtifactAssessment.disposition
        Definition

        Indicates the disposition of the responsible party to the comment or change request.

        Shortunresolved | not-persuasive | persuasive | persuasive-with-modification | not-persuasive-with-modification
        Control0..1
        BindingThe codes SHALL be taken from ArtifactAssessmentDisposition
        (required to http://hl7.org/fhir/ValueSet/artifactassessment-disposition|5.0.0)
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))