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: ComparativeBaselineMeasureEvidence - Detailed Descriptions

Page standards status: Draft Maturity Level: 1

Definitions for the comparative-baseline-measure-evidence resource profile.

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

0. Evidence
2. Evidence.variableDefinition
Comments

The Baseline Measure (or independent variable) has variableRole of outcome.

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

0. Evidence
Definition

The Evidence Resource provides a machine-interpretable expression of an evidence concept including the evidence variables (e.g., population, exposures/interventions, comparators, outcomes, measured variables, confounding variables), the statistics, and the certainty of this evidence.

ShortSingle evidence bit
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantscnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$'))
2. Evidence.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. Evidence.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. Evidence.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())
8. Evidence.status
Definition

The status of this summary. Enables tracking the life-cycle of the content.

Shortdraft | active | retired | unknown
Comments

Allows filtering of summarys s that are appropriate for use versus not.

See guidance around (not) making local changes to elements here.

Control1..1
BindingThe codes SHALL be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status|5.0.0
(required to http://hl7.org/fhir/ValueSet/publication-status|5.0.0)

The lifecycle status of an artifact.

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
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()))
10. Evidence.variableDefinition
Definition

Evidence variable such as population, exposure, or outcome.

ShortEvidence variable such as population, exposure, or outcome
Comments

The Baseline Measure (or independent variable) has variableRole of outcome.

Control31..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Evidence.variableDefinition. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ note.text
  • 12. Evidence.variableDefinition.extension
    Definition

    An Extension


    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.

    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.

    Control10..*
    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())
    SlicingThis element introduces a set of slices on Evidence.variableDefinition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 14. Evidence.variableDefinition.extension:variableRoleCode
      Slice NamevariableRoleCode
      Definition

      Classification of the role of the variable.

      Shortpopulation | exposure | outcome | covariate
      Control1..1
      TypeExtension(VariableDefinitionVariableRoleCode) (Extension Type: code)
      Is Modifierfalse
      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. Evidence.variableDefinition.extension:roleSubtype
      Slice NameroleSubtype
      Definition

      Sub-classification of the role of the variable.

      Shortsubgroup | variable-A | variable-B | variable-AB | confounder | collider | mediator | effect-modifier
      Control0..1
      TypeExtension(VariableDefinitionRoleSubtype) (Extension Type: CodeableConcept)
      Is Modifierfalse
      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. Evidence.variableDefinition.extension:comparatorCategory
      Slice NamecomparatorCategory
      Definition

      The reference value used for comparison. Value should match EvidenceVariable.category.name in the EvidenceVariable referenced in the observed or intended element.

      ShortThe reference value used for comparison
      Control0..1
      TypeExtension(VariableDefinitionComparatorCategory) (Extension Type: string)
      Is Modifierfalse
      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. Evidence.variableDefinition.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())
      22. Evidence.variableDefinition.variableRole
      Definition

      population | subpopulation | exposure | referenceExposure | measuredVariable | confounder.

      Shortpopulation | subpopulation | exposure | referenceExposure | measuredVariable | confounder
      Control1..1
      BindingUnless not suitable, these codes SHALL be taken from EvidenceVariableRolehttp://hl7.org/fhir/ValueSet/variable-role
      (extensible to http://hl7.org/fhir/ValueSet/variable-role)

      The role that the assertion variable plays.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Evidence.variableDefinition:population
      Slice Namepopulation
      Definition

      Evidence variable such as population, exposure, or outcome.

      ShortEvidence variable such as population, exposure, or outcome
      Control1..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Evidence.variableDefinition:population.extension
      Definition

      An Extension


      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.

      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.

      Control10..*
      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())
      SlicingThis element introduces a set of slices on Evidence.variableDefinition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 28. Evidence.variableDefinition:population.extension:variableRoleCode
        Slice NamevariableRoleCode
        Definition

        Classification of the role of the variable.

        Shortpopulation | exposure | outcome | covariate
        Control1..1
        TypeExtension(VariableDefinitionVariableRoleCode) (Extension Type: code)
        Is Modifierfalse
        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())
        30. Evidence.variableDefinition:population.extension:variableRoleCode.extension
        Definition

        An Extension


        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.

        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..0*
        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())
        SlicingThis element introduces a set of slices on Evidence.variableDefinition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 32. Evidence.variableDefinition:population.extension:variableRoleCode.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttp://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code
          34. Evidence.variableDefinition:population.extension:roleSubtype
          Slice NameroleSubtype
          Definition

          Sub-classification of the role of the variable.

          Shortsubgroup | variable-A | variable-B | variable-AB | confounder | collider | mediator | effect-modifier
          Control0..1
          TypeExtension(VariableDefinitionRoleSubtype) (Extension Type: CodeableConcept)
          Is Modifierfalse
          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())
          36. Evidence.variableDefinition:population.extension:comparatorCategory
          Slice NamecomparatorCategory
          Definition

          The reference value used for comparison. Value should match EvidenceVariable.category.name in the EvidenceVariable referenced in the observed or intended element.

          ShortThe reference value used for comparison
          Control0..1
          TypeExtension(VariableDefinitionComparatorCategory) (Extension Type: string)
          Is Modifierfalse
          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())
          38. Evidence.variableDefinition:population.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())
          40. Evidence.variableDefinition:population.variableRole
          Definition

          population | subpopulation | exposure | referenceExposure | measuredVariable | confounder.

          Shortpopulation | subpopulation | exposure | referenceExposure | measuredVariable | confounder
          Control1..1
          BindingUnless not suitable, these codes SHALL be taken from EvidenceVariableRolehttp://hl7.org/fhir/ValueSet/variable-role
          (extensible to http://hl7.org/fhir/ValueSet/variable-role)

          The role that the assertion variable plays.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. Evidence.variableDefinition:exposure
          Slice Nameexposure
          Definition

          Evidence variable such as population, exposure, or outcome.

          ShortEvidence variable such as population, exposure, or outcome
          Control1..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. Evidence.variableDefinition:exposure.extension
          Definition

          An Extension


          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.

          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.

          Control20..*
          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())
          SlicingThis element introduces a set of slices on Evidence.variableDefinition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 46. Evidence.variableDefinition:exposure.extension:variableRoleCode
            Slice NamevariableRoleCode
            Definition

            Classification of the role of the variable.

            Shortpopulation | exposure | outcome | covariate
            Control1..1
            TypeExtension(VariableDefinitionVariableRoleCode) (Extension Type: code)
            Is Modifierfalse
            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. Evidence.variableDefinition:exposure.extension:variableRoleCode.extension
            Definition

            An Extension


            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.

            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..0*
            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())
            SlicingThis element introduces a set of slices on Evidence.variableDefinition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 50. Evidence.variableDefinition:exposure.extension:variableRoleCode.url
              Definition

              Source of the definition for the extension code - a logical name or a URL.

              Shortidentifies the meaning of the extension
              Comments

              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

              Control1..1
              Typeuri
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              Fixed Valuehttp://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code
              52. Evidence.variableDefinition:exposure.extension:roleSubtype
              Slice NameroleSubtype
              Definition

              Sub-classification of the role of the variable.

              Shortsubgroup | variable-A | variable-B | variable-AB | confounder | collider | mediator | effect-modifier
              Control0..1
              TypeExtension(VariableDefinitionRoleSubtype) (Extension Type: CodeableConcept)
              Is Modifierfalse
              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())
              54. Evidence.variableDefinition:exposure.extension:comparatorCategory
              Slice NamecomparatorCategory
              Definition

              The reference value used for comparison. Value should match EvidenceVariable.category.name in the EvidenceVariable referenced in the observed or intended element.

              ShortThe reference value used for comparison
              Control1..1
              TypeExtension(VariableDefinitionComparatorCategory) (Extension Type: string)
              Is Modifierfalse
              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())
              56. Evidence.variableDefinition:exposure.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())
              58. Evidence.variableDefinition:exposure.variableRole
              Definition

              population | subpopulation | exposure | referenceExposure | measuredVariable | confounder.

              Shortpopulation | subpopulation | exposure | referenceExposure | measuredVariable | confounder
              Control1..1
              BindingUnless not suitable, these codes SHALL be taken from EvidenceVariableRolehttp://hl7.org/fhir/ValueSet/variable-role
              (extensible to http://hl7.org/fhir/ValueSet/variable-role)

              The role that the assertion variable plays.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              60. Evidence.variableDefinition:outcome
              Slice Nameoutcome
              Definition

              Evidence variable such as population, exposure, or outcome.

              ShortEvidence variable such as population, exposure, or outcome
              Control1..*
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              62. Evidence.variableDefinition:outcome.extension
              Definition

              An Extension


              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.

              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.

              Control10..*
              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())
              SlicingThis element introduces a set of slices on Evidence.variableDefinition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 64. Evidence.variableDefinition:outcome.extension:variableRoleCode
                Slice NamevariableRoleCode
                Definition

                Classification of the role of the variable.

                Shortpopulation | exposure | outcome | covariate
                Control1..1
                TypeExtension(VariableDefinitionVariableRoleCode) (Extension Type: code)
                Is Modifierfalse
                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())
                66. Evidence.variableDefinition:outcome.extension:variableRoleCode.extension
                Definition

                An Extension


                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.

                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..0*
                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())
                SlicingThis element introduces a set of slices on Evidence.variableDefinition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 68. Evidence.variableDefinition:outcome.extension:variableRoleCode.url
                  Definition

                  Source of the definition for the extension code - a logical name or a URL.

                  Shortidentifies the meaning of the extension
                  Comments

                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  Fixed Valuehttp://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code
                  70. Evidence.variableDefinition:outcome.extension:roleSubtype
                  Slice NameroleSubtype
                  Definition

                  Sub-classification of the role of the variable.

                  Shortsubgroup | variable-A | variable-B | variable-AB | confounder | collider | mediator | effect-modifier
                  Control0..1
                  TypeExtension(VariableDefinitionRoleSubtype) (Extension Type: CodeableConcept)
                  Is Modifierfalse
                  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())
                  72. Evidence.variableDefinition:outcome.extension:comparatorCategory
                  Slice NamecomparatorCategory
                  Definition

                  The reference value used for comparison. Value should match EvidenceVariable.category.name in the EvidenceVariable referenced in the observed or intended element.

                  ShortThe reference value used for comparison
                  Control0..0
                  TypeExtension(VariableDefinitionComparatorCategory) (Extension Type: string)
                  Is Modifierfalse
                  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())
                  74. Evidence.variableDefinition:outcome.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())
                  76. Evidence.variableDefinition:outcome.variableRole
                  Definition

                  population | subpopulation | exposure | referenceExposure | measuredVariable | confounder.

                  Shortpopulation | subpopulation | exposure | referenceExposure | measuredVariable | confounder
                  Control1..1
                  BindingUnless not suitable, these codes SHALL be taken from EvidenceVariableRolehttp://hl7.org/fhir/ValueSet/variable-role
                  (extensible to http://hl7.org/fhir/ValueSet/variable-role)

                  The role that the assertion variable plays.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  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. Evidence
                  Definition

                  The Evidence Resource provides a machine-interpretable expression of an evidence concept including the evidence variables (e.g., population, exposures/interventions, comparators, outcomes, measured variables, confounding variables), the statistics, and the certainty of this evidence.

                  ShortSingle evidence bit
                  Control0..*
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Invariantscnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$'))
                  2. Evidence.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. Evidence.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. Evidence.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. Evidence.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. Evidence.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. Evidence.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. Evidence.extension
                  Definition

                  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.

                  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
                  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())
                  16. Evidence.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())
                  18. Evidence.url
                  Definition

                  An absolute URI that is used to identify this evidence 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 summary is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the summary is stored on different servers.

                  ShortCanonical identifier for this evidence, represented as a globally unique URI
                  Comments

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

                  Allows the evidence to be referenced by a single globally unique identifier.

                  Invariantscnl-1: URL should not contain | or # - these characters make processing canonical references problematic (exists() implies matches('^[^|# ]+$'))
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  20. Evidence.identifier
                  Definition

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

                  ShortAdditional identifier for the summary
                  Comments

                  Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this summary 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 module.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  22. Evidence.version
                  Definition

                  The identifier that is used to identify this version of the summary when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the summary author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

                  ShortBusiness version of this summary
                  Comments

                  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.

                  NoteThis is a business version Id, not a resource version Id (see discussion)
                  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()))
                  24. Evidence.versionAlgorithm[x]
                  Definition

                  Indicates the mechanism used to compare versions to determine which is more current.

                  ShortHow to compare versions
                  Comments

                  If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 is newer, and a 0 if the version ordering can't successfully be determined.

                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from VersionAlgorithm
                  (extensible to http://hl7.org/fhir/ValueSet/version-algorithm)
                  TypeChoice of: string, Coding
                  [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()))
                  26. Evidence.name
                  Definition

                  A natural language name identifying the evidence. This name should be usable as an identifier for the module by machine processing applications such as code generation.

                  ShortName for this summary (machine friendly)
                  Comments

                  The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

                  Control0..1
                  This element is affected by the following invariants: cnl-0
                  Typestring
                  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()))
                  28. Evidence.title
                  Definition

                  A short, descriptive, user-friendly title for the summary.

                  ShortName for this summary (human friendly)
                  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()))
                  30. Evidence.citeAs[x]
                  Definition

                  Citation Resource or display of suggested citation for this evidence.

                  ShortCitation for this evidence
                  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()))
                  32. Evidence.status
                  Definition

                  The status of this summary. Enables tracking the life-cycle of the content.

                  Shortdraft | active | retired | unknown
                  Comments

                  Allows filtering of summarys s that are appropriate for use versus not.

                  See guidance around (not) making local changes to elements here.

                  Control1..1
                  BindingThe codes SHALL be taken from PublicationStatus
                  (required to http://hl7.org/fhir/ValueSet/publication-status|5.0.0)

                  The lifecycle status of an artifact.

                  Typecode
                  Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
                  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()))
                  34. Evidence.experimental
                  Definition

                  A Boolean value to indicate that this resource is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

                  ShortFor testing purposes, not real usage
                  Control0..1
                  Typeboolean
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summaryfalse
                  Meaning if MissingIf absent, this resource is treated as though it is not experimental.
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  36. Evidence.date
                  Definition

                  The date (and optionally time) when the summary was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the summary 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 summary. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

                  See guidance around (not) making local changes to elements here.

                  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()))
                  38. Evidence.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 summary was approved by publisher
                  Comments

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

                  See guidance around (not) making local changes to elements here.

                  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()))
                  40. Evidence.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 summary was last reviewed by the publisher
                  Comments

                  If specified, this date follows the original approval date.

                  See guidance around (not) making local changes to elements here.

                  Control0..1
                  Typedate
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summaryfalse
                  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()))
                  42. Evidence.publisher
                  Definition

                  The name of the organization or individual responsible for the release and ongoing maintenance of the evidence.

                  ShortName of the publisher/steward (organization or individual)
                  Comments

                  Usually an organization but may be an individual. The publisher (or steward) of the evidence is the organization or individual primarily responsible for the maintenance and upkeep of the evidence. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the evidence. This item SHOULD be populated unless the information is available from context.

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

                  Helps establish the "authority/credibility" of the evidence. May also allow for contact.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  44. Evidence.contact
                  Definition

                  Contact details to assist a user in finding and communicating with the publisher.

                  ShortContact details for the publisher
                  Comments

                  Extensions to ContactDetail include: contactReference, contactAddress, and contributionTime (see Clinical Reasoning Module).

                  See guidance around (not) making local changes to elements here.

                  Control0..*
                  TypeContactDetail
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  46. Evidence.author
                  Definition

                  An individiual, organization, or device primarily involved in the creation and maintenance of the content.

                  ShortWho authored the content
                  Comments

                  Extensions to ContactDetail include: contactReference, contactAddress, and contributionTime (see Clinical Reasoning Module).

                  Control0..*
                  TypeContactDetail
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  48. Evidence.editor
                  Definition

                  An individiual, organization, or device primarily responsible for internal coherence of the content.

                  ShortWho edited the content
                  Comments

                  Extensions to ContactDetail include: contactReference, contactAddress, and contributionTime (see Clinical Reasoning Module).

                  Control0..*
                  TypeContactDetail
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  50. Evidence.reviewer
                  Definition

                  An individiual, organization, or device primarily responsible for review of some aspect of the content.

                  ShortWho reviewed the content
                  Comments

                  Extensions to ContactDetail include: contactReference, contactAddress, and contributionTime (see Clinical Reasoning Module).

                  See guidance around (not) making local changes to elements here.

                  Control0..*
                  TypeContactDetail
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  52. Evidence.endorser
                  Definition

                  An individiual, organization, or device responsible for officially endorsing the content for use in some setting.

                  ShortWho endorsed the content
                  Comments

                  Extensions to ContactDetail include: contactReference, contactAddress, and contributionTime (see Clinical Reasoning Module).

                  See guidance around (not) making local changes to elements here.

                  Control0..*
                  TypeContactDetail
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  54. Evidence.useContext
                  Definition

                  The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate evidence instances.

                  ShortThe context that the content is intended to support
                  Comments

                  When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

                  Control0..*
                  TypeUsageContext
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Requirements

                  Assist in searching for appropriate content.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. Evidence.purpose
                  Definition

                  Explanation of why this Evidence is needed and why it has been designed as it has.

                  ShortWhy this Evidence is defined
                  Comments

                  This element does not describe the usage of the Evidence. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this Evidence.

                  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()))
                  58. Evidence.copyright
                  Definition

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

                  ShortUse and/or publishing restrictions
                  Comments

                  The short copyright declaration (e.g. (c) '2015+ xyz organization' should be sent in the copyrightLabel element.

                  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 Evidence and/or its content.

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

                  A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').

                  ShortCopyright holder and year(s)
                  Comments

                  The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

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

                  Defines the content expected to be rendered in all representations of the artifact.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  62. Evidence.relatedArtifact
                  Definition

                  Link or citation to artifact associated with the summary.

                  ShortLink or citation to artifact associated with the summary
                  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. Evidence.description
                  Definition

                  A free text natural language description of the evidence from a consumer's perspective.

                  ShortDescription of the particular summary
                  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 evidence 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 evidence is presumed to be the predominant language in the place the evidence was created).

                  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()))
                  66. Evidence.assertion
                  Definition

                  Declarative description of the Evidence.

                  ShortDeclarative description of the Evidence
                  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()))
                  68. Evidence.note
                  Definition

                  Footnotes and/or explanatory notes.

                  ShortFootnotes and/or explanatory notes
                  Control0..*
                  TypeAnnotation
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  70. Evidence.variableDefinition
                  Definition

                  Evidence variable such as population, exposure, or outcome.

                  ShortEvidence variable such as population, exposure, or outcome
                  Comments

                  The Baseline Measure (or independent variable) has variableRole of outcome.

                  Control3..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on Evidence.variableDefinition. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ note.text
                  • 72. Evidence.variableDefinition.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
                    74. Evidence.variableDefinition.extension
                    Definition

                    An Extension

                    ShortExtension
                    Control1..*
                    TypeExtension
                    Is Modifierfalse
                    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 Evidence.variableDefinition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 76. Evidence.variableDefinition.extension:variableRoleCode
                      Slice NamevariableRoleCode
                      Definition

                      Classification of the role of the variable.

                      Shortpopulation | exposure | outcome | covariate
                      Control1..1
                      TypeExtension(VariableDefinitionVariableRoleCode) (Extension Type: code)
                      Is Modifierfalse
                      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())
                      78. Evidence.variableDefinition.extension:roleSubtype
                      Slice NameroleSubtype
                      Definition

                      Sub-classification of the role of the variable.

                      Shortsubgroup | variable-A | variable-B | variable-AB | confounder | collider | mediator | effect-modifier
                      Control0..1
                      TypeExtension(VariableDefinitionRoleSubtype) (Extension Type: CodeableConcept)
                      Is Modifierfalse
                      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())
                      80. Evidence.variableDefinition.extension:comparatorCategory
                      Slice NamecomparatorCategory
                      Definition

                      The reference value used for comparison. Value should match EvidenceVariable.category.name in the EvidenceVariable referenced in the observed or intended element.

                      ShortThe reference value used for comparison
                      Control0..1
                      TypeExtension(VariableDefinitionComparatorCategory) (Extension Type: string)
                      Is Modifierfalse
                      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())
                      82. Evidence.variableDefinition.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())
                      84. Evidence.variableDefinition.description
                      Definition

                      A text description or summary of the variable.

                      ShortA text description or summary of the variable
                      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()))
                      86. Evidence.variableDefinition.note
                      Definition

                      Footnotes and/or explanatory notes.

                      ShortFootnotes and/or explanatory notes
                      Control0..*
                      TypeAnnotation
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      88. Evidence.variableDefinition.variableRole
                      Definition

                      population | subpopulation | exposure | referenceExposure | measuredVariable | confounder.

                      Shortpopulation | subpopulation | exposure | referenceExposure | measuredVariable | confounder
                      Control1..1
                      BindingUnless not suitable, these codes SHALL be taken from EvidenceVariableRole
                      (extensible to http://hl7.org/fhir/ValueSet/variable-role)

                      The role that the assertion variable plays.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      90. Evidence.variableDefinition.variableRole.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
                      Typeid
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      92. Evidence.variableDefinition.variableRole.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())
                      SlicingThis element introduces a set of slices on Evidence.variableDefinition.variableRole.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 94. Evidence.variableDefinition.variableRole.coding
                        Definition

                        A reference to a code defined by a terminology system.

                        ShortCode defined by a terminology system
                        Comments

                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                        Control0..*
                        TypeCoding
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        Allows for alternative encodings within a code system, and translations to other code systems.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        96. Evidence.variableDefinition.variableRole.text
                        Definition

                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                        ShortPlain text representation of the concept
                        Comments

                        Very often the text is the same as a displayName of one of the codings.

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

                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                        Pattern ValueUse extension:variableRoleCode instead.
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        98. Evidence.variableDefinition.observed
                        Definition

                        Definition of the actual variable related to the statistic(s).

                        ShortDefinition of the actual variable related to the statistic(s)
                        Control0..1
                        TypeReference(Group, EvidenceVariable)
                        Is Modifierfalse
                        Must Supportfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        100. Evidence.variableDefinition.intended
                        Definition

                        Definition of the intended variable related to the Evidence.

                        ShortDefinition of the intended variable related to the Evidence
                        Control0..1
                        TypeReference(Group, EvidenceVariable)
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        102. Evidence.variableDefinition.directnessMatch
                        Definition

                        Indication of quality of match between intended variable to actual variable.

                        Shortlow | moderate | high | exact
                        Control0..1
                        BindingUnless not suitable, these codes SHALL be taken from EvidenceDirectness
                        (extensible to http://terminology.hl7.org/ValueSet/directness)

                        The quality of how direct the match is.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        104. Evidence.variableDefinition:population
                        Slice Namepopulation
                        Definition

                        Evidence variable such as population, exposure, or outcome.

                        ShortEvidence variable such as population, exposure, or outcome
                        Control1..*
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        106. Evidence.variableDefinition:population.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
                        108. Evidence.variableDefinition:population.extension
                        Definition

                        An Extension

                        ShortExtension
                        Control1..*
                        TypeExtension
                        Is Modifierfalse
                        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 Evidence.variableDefinition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 110. Evidence.variableDefinition:population.extension:variableRoleCode
                          Slice NamevariableRoleCode
                          Definition

                          Classification of the role of the variable.

                          Shortpopulation | exposure | outcome | covariate
                          Control1..1
                          TypeExtension(VariableDefinitionVariableRoleCode) (Extension Type: code)
                          Is Modifierfalse
                          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())
                          112. Evidence.variableDefinition:population.extension:variableRoleCode.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
                          Typeid
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          114. Evidence.variableDefinition:population.extension:variableRoleCode.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control0..0
                          TypeExtension
                          Is Modifierfalse
                          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 Evidence.variableDefinition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 116. Evidence.variableDefinition:population.extension:variableRoleCode.url
                            Definition

                            Source of the definition for the extension code - a logical name or a URL.

                            Shortidentifies the meaning of the extension
                            Comments

                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                            Control1..1
                            Typeuri
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            Fixed Valuehttp://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code
                            118. Evidence.variableDefinition:population.extension:variableRoleCode.value[x]
                            Definition

                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                            ShortValue of extension
                            Control0..1
                            This element is affected by the following invariants: ext-1
                            Typecode
                            [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
                            Summaryfalse
                            Pattern Valuepopulation
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            120. Evidence.variableDefinition:population.extension:roleSubtype
                            Slice NameroleSubtype
                            Definition

                            Sub-classification of the role of the variable.

                            Shortsubgroup | variable-A | variable-B | variable-AB | confounder | collider | mediator | effect-modifier
                            Control0..1
                            TypeExtension(VariableDefinitionRoleSubtype) (Extension Type: CodeableConcept)
                            Is Modifierfalse
                            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())
                            122. Evidence.variableDefinition:population.extension:comparatorCategory
                            Slice NamecomparatorCategory
                            Definition

                            The reference value used for comparison. Value should match EvidenceVariable.category.name in the EvidenceVariable referenced in the observed or intended element.

                            ShortThe reference value used for comparison
                            Control0..1
                            TypeExtension(VariableDefinitionComparatorCategory) (Extension Type: string)
                            Is Modifierfalse
                            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())
                            124. Evidence.variableDefinition:population.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())
                            126. Evidence.variableDefinition:population.description
                            Definition

                            A text description or summary of the variable.

                            ShortA text description or summary of the variable
                            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()))
                            128. Evidence.variableDefinition:population.note
                            Definition

                            Footnotes and/or explanatory notes.

                            ShortFootnotes and/or explanatory notes
                            Control0..*
                            TypeAnnotation
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            130. Evidence.variableDefinition:population.note.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
                            Typeid
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            132. Evidence.variableDefinition:population.note.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())
                            SlicingThis element introduces a set of slices on Evidence.variableDefinition.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 134. Evidence.variableDefinition:population.note.author[x]
                              Definition

                              The individual responsible for making the annotation.

                              ShortIndividual responsible for the annotation
                              Comments

                              Organization is used when there's no need for specific attribution as to who made the comment.

                              Control0..1
                              TypeChoice of: Reference(Practitioner, PractitionerRole, Patient, RelatedPerson, Organization), string
                              [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
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              136. Evidence.variableDefinition:population.note.time
                              Definition

                              Indicates when this particular annotation was made.

                              ShortWhen the annotation was made
                              Control0..1
                              TypedateTime
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              138. Evidence.variableDefinition:population.note.text
                              Definition

                              The text of the annotation in markdown format.

                              ShortThe annotation - text content (as markdown)
                              Control1..1
                              Typemarkdown
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Pattern Valuepopulation
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              140. Evidence.variableDefinition:population.variableRole
                              Definition

                              population | subpopulation | exposure | referenceExposure | measuredVariable | confounder.

                              Shortpopulation | subpopulation | exposure | referenceExposure | measuredVariable | confounder
                              Control1..1
                              BindingUnless not suitable, these codes SHALL be taken from EvidenceVariableRole
                              (extensible to http://hl7.org/fhir/ValueSet/variable-role)

                              The role that the assertion variable plays.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              142. Evidence.variableDefinition:population.variableRole.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
                              Typeid
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              144. Evidence.variableDefinition:population.variableRole.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())
                              SlicingThis element introduces a set of slices on Evidence.variableDefinition.variableRole.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 146. Evidence.variableDefinition:population.variableRole.coding
                                Definition

                                A reference to a code defined by a terminology system.

                                ShortCode defined by a terminology system
                                Comments

                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                Control0..*
                                TypeCoding
                                Is Modifierfalse
                                Summarytrue
                                Requirements

                                Allows for alternative encodings within a code system, and translations to other code systems.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                148. Evidence.variableDefinition:population.variableRole.text
                                Definition

                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                ShortPlain text representation of the concept
                                Comments

                                Very often the text is the same as a displayName of one of the codings.

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

                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                Pattern ValueUse extension:variableRoleCode instead.
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                150. Evidence.variableDefinition:population.observed
                                Definition

                                Definition of the actual variable related to the statistic(s).

                                ShortDefinition of the actual variable related to the statistic(s)
                                Control0..1
                                TypeReference(StudyGroup, ExposureGroup, ComparatorGroup, MetaanalysisStudyGroup)
                                Is Modifierfalse
                                Must Supportfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                152. Evidence.variableDefinition:population.intended
                                Definition

                                Definition of the intended variable related to the Evidence.

                                ShortDefinition of the intended variable related to the Evidence
                                Control0..1
                                TypeReference(Group)
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                154. Evidence.variableDefinition:population.directnessMatch
                                Definition

                                Indication of quality of match between intended variable to actual variable.

                                Shortlow | moderate | high | exact
                                Control0..1
                                BindingUnless not suitable, these codes SHALL be taken from EvidenceDirectness
                                (extensible to http://terminology.hl7.org/ValueSet/directness)

                                The quality of how direct the match is.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                156. Evidence.variableDefinition:exposure
                                Slice Nameexposure
                                Definition

                                Evidence variable such as population, exposure, or outcome.

                                ShortEvidence variable such as population, exposure, or outcome
                                Control1..1
                                TypeBackboneElement
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                158. Evidence.variableDefinition:exposure.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
                                160. Evidence.variableDefinition:exposure.extension
                                Definition

                                An Extension

                                ShortExtension
                                Control2..*
                                TypeExtension
                                Is Modifierfalse
                                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 Evidence.variableDefinition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 162. Evidence.variableDefinition:exposure.extension:variableRoleCode
                                  Slice NamevariableRoleCode
                                  Definition

                                  Classification of the role of the variable.

                                  Shortpopulation | exposure | outcome | covariate
                                  Control1..1
                                  TypeExtension(VariableDefinitionVariableRoleCode) (Extension Type: code)
                                  Is Modifierfalse
                                  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())
                                  164. Evidence.variableDefinition:exposure.extension:variableRoleCode.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
                                  Typeid
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  166. Evidence.variableDefinition:exposure.extension:variableRoleCode.extension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Control0..0
                                  TypeExtension
                                  Is Modifierfalse
                                  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 Evidence.variableDefinition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 168. Evidence.variableDefinition:exposure.extension:variableRoleCode.url
                                    Definition

                                    Source of the definition for the extension code - a logical name or a URL.

                                    Shortidentifies the meaning of the extension
                                    Comments

                                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                    Control1..1
                                    Typeuri
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    Fixed Valuehttp://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code
                                    170. Evidence.variableDefinition:exposure.extension:variableRoleCode.value[x]
                                    Definition

                                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                    ShortValue of extension
                                    Control0..1
                                    This element is affected by the following invariants: ext-1
                                    Typecode
                                    [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
                                    Summaryfalse
                                    Pattern Valueexposure
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    172. Evidence.variableDefinition:exposure.extension:roleSubtype
                                    Slice NameroleSubtype
                                    Definition

                                    Sub-classification of the role of the variable.

                                    Shortsubgroup | variable-A | variable-B | variable-AB | confounder | collider | mediator | effect-modifier
                                    Control0..1
                                    TypeExtension(VariableDefinitionRoleSubtype) (Extension Type: CodeableConcept)
                                    Is Modifierfalse
                                    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())
                                    174. Evidence.variableDefinition:exposure.extension:comparatorCategory
                                    Slice NamecomparatorCategory
                                    Definition

                                    The reference value used for comparison. Value should match EvidenceVariable.category.name in the EvidenceVariable referenced in the observed or intended element.

                                    ShortThe reference value used for comparison
                                    Control1..1
                                    TypeExtension(VariableDefinitionComparatorCategory) (Extension Type: string)
                                    Is Modifierfalse
                                    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())
                                    176. Evidence.variableDefinition:exposure.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())
                                    178. Evidence.variableDefinition:exposure.description
                                    Definition

                                    A text description or summary of the variable.

                                    ShortA text description or summary of the variable
                                    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()))
                                    180. Evidence.variableDefinition:exposure.note
                                    Definition

                                    Footnotes and/or explanatory notes.

                                    ShortFootnotes and/or explanatory notes
                                    Control0..*
                                    TypeAnnotation
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    182. Evidence.variableDefinition:exposure.note.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
                                    Typeid
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    184. Evidence.variableDefinition:exposure.note.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())
                                    SlicingThis element introduces a set of slices on Evidence.variableDefinition.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 186. Evidence.variableDefinition:exposure.note.author[x]
                                      Definition

                                      The individual responsible for making the annotation.

                                      ShortIndividual responsible for the annotation
                                      Comments

                                      Organization is used when there's no need for specific attribution as to who made the comment.

                                      Control0..1
                                      TypeChoice of: Reference(Practitioner, PractitionerRole, Patient, RelatedPerson, Organization), string
                                      [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
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      188. Evidence.variableDefinition:exposure.note.time
                                      Definition

                                      Indicates when this particular annotation was made.

                                      ShortWhen the annotation was made
                                      Control0..1
                                      TypedateTime
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      190. Evidence.variableDefinition:exposure.note.text
                                      Definition

                                      The text of the annotation in markdown format.

                                      ShortThe annotation - text content (as markdown)
                                      Control1..1
                                      Typemarkdown
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Pattern Valueexposure
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      192. Evidence.variableDefinition:exposure.variableRole
                                      Definition

                                      population | subpopulation | exposure | referenceExposure | measuredVariable | confounder.

                                      Shortpopulation | subpopulation | exposure | referenceExposure | measuredVariable | confounder
                                      Control1..1
                                      BindingUnless not suitable, these codes SHALL be taken from EvidenceVariableRole
                                      (extensible to http://hl7.org/fhir/ValueSet/variable-role)

                                      The role that the assertion variable plays.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      194. Evidence.variableDefinition:exposure.variableRole.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
                                      Typeid
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      196. Evidence.variableDefinition:exposure.variableRole.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())
                                      SlicingThis element introduces a set of slices on Evidence.variableDefinition.variableRole.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 198. Evidence.variableDefinition:exposure.variableRole.coding
                                        Definition

                                        A reference to a code defined by a terminology system.

                                        ShortCode defined by a terminology system
                                        Comments

                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                        Control0..*
                                        TypeCoding
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        200. Evidence.variableDefinition:exposure.variableRole.text
                                        Definition

                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                        ShortPlain text representation of the concept
                                        Comments

                                        Very often the text is the same as a displayName of one of the codings.

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

                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                        Pattern ValueUse extension:variableRoleCode instead.
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        202. Evidence.variableDefinition:exposure.observed
                                        Definition

                                        Definition of the actual variable related to the statistic(s).

                                        ShortDefinition of the actual variable related to the statistic(s)
                                        Control0..1
                                        TypeReference(GroupAssignment)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        204. Evidence.variableDefinition:exposure.intended
                                        Definition

                                        Definition of the intended variable related to the Evidence.

                                        ShortDefinition of the intended variable related to the Evidence
                                        Control0..1
                                        TypeReference(VariableDefinition)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        206. Evidence.variableDefinition:exposure.directnessMatch
                                        Definition

                                        Indication of quality of match between intended variable to actual variable.

                                        Shortlow | moderate | high | exact
                                        Control0..1
                                        BindingUnless not suitable, these codes SHALL be taken from EvidenceDirectness
                                        (extensible to http://terminology.hl7.org/ValueSet/directness)

                                        The quality of how direct the match is.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        208. Evidence.variableDefinition:outcome
                                        Slice Nameoutcome
                                        Definition

                                        Evidence variable such as population, exposure, or outcome.

                                        ShortEvidence variable such as population, exposure, or outcome
                                        Control1..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        210. Evidence.variableDefinition:outcome.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
                                        212. Evidence.variableDefinition:outcome.extension
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control1..*
                                        TypeExtension
                                        Is Modifierfalse
                                        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 Evidence.variableDefinition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 214. Evidence.variableDefinition:outcome.extension:variableRoleCode
                                          Slice NamevariableRoleCode
                                          Definition

                                          Classification of the role of the variable.

                                          Shortpopulation | exposure | outcome | covariate
                                          Control1..1
                                          TypeExtension(VariableDefinitionVariableRoleCode) (Extension Type: code)
                                          Is Modifierfalse
                                          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())
                                          216. Evidence.variableDefinition:outcome.extension:variableRoleCode.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
                                          Typeid
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          218. Evidence.variableDefinition:outcome.extension:variableRoleCode.extension
                                          Definition

                                          An Extension

                                          ShortExtension
                                          Control0..0
                                          TypeExtension
                                          Is Modifierfalse
                                          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 Evidence.variableDefinition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 220. Evidence.variableDefinition:outcome.extension:variableRoleCode.url
                                            Definition

                                            Source of the definition for the extension code - a logical name or a URL.

                                            Shortidentifies the meaning of the extension
                                            Comments

                                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                            Control1..1
                                            Typeuri
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            Fixed Valuehttp://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code
                                            222. Evidence.variableDefinition:outcome.extension:variableRoleCode.value[x]
                                            Definition

                                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                            ShortValue of extension
                                            Control0..1
                                            This element is affected by the following invariants: ext-1
                                            Typecode
                                            [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
                                            Summaryfalse
                                            Pattern Valueoutcome
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            224. Evidence.variableDefinition:outcome.extension:roleSubtype
                                            Slice NameroleSubtype
                                            Definition

                                            Sub-classification of the role of the variable.

                                            Shortsubgroup | variable-A | variable-B | variable-AB | confounder | collider | mediator | effect-modifier
                                            Control0..1
                                            TypeExtension(VariableDefinitionRoleSubtype) (Extension Type: CodeableConcept)
                                            Is Modifierfalse
                                            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())
                                            226. Evidence.variableDefinition:outcome.extension:comparatorCategory
                                            Slice NamecomparatorCategory
                                            Definition

                                            The reference value used for comparison. Value should match EvidenceVariable.category.name in the EvidenceVariable referenced in the observed or intended element.

                                            ShortThe reference value used for comparison
                                            Control0..0
                                            TypeExtension(VariableDefinitionComparatorCategory) (Extension Type: string)
                                            Is Modifierfalse
                                            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())
                                            228. Evidence.variableDefinition:outcome.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())
                                            230. Evidence.variableDefinition:outcome.description
                                            Definition

                                            A text description or summary of the variable.

                                            ShortA text description or summary of the variable
                                            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()))
                                            232. Evidence.variableDefinition:outcome.note
                                            Definition

                                            Footnotes and/or explanatory notes.

                                            ShortFootnotes and/or explanatory notes
                                            Control0..*
                                            TypeAnnotation
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            234. Evidence.variableDefinition:outcome.note.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
                                            Typeid
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            236. Evidence.variableDefinition:outcome.note.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())
                                            SlicingThis element introduces a set of slices on Evidence.variableDefinition.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 238. Evidence.variableDefinition:outcome.note.author[x]
                                              Definition

                                              The individual responsible for making the annotation.

                                              ShortIndividual responsible for the annotation
                                              Comments

                                              Organization is used when there's no need for specific attribution as to who made the comment.

                                              Control0..1
                                              TypeChoice of: Reference(Practitioner, PractitionerRole, Patient, RelatedPerson, Organization), string
                                              [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
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              240. Evidence.variableDefinition:outcome.note.time
                                              Definition

                                              Indicates when this particular annotation was made.

                                              ShortWhen the annotation was made
                                              Control0..1
                                              TypedateTime
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              242. Evidence.variableDefinition:outcome.note.text
                                              Definition

                                              The text of the annotation in markdown format.

                                              ShortThe annotation - text content (as markdown)
                                              Control1..1
                                              Typemarkdown
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Pattern Valueoutcome
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              244. Evidence.variableDefinition:outcome.variableRole
                                              Definition

                                              population | subpopulation | exposure | referenceExposure | measuredVariable | confounder.

                                              Shortpopulation | subpopulation | exposure | referenceExposure | measuredVariable | confounder
                                              Control1..1
                                              BindingUnless not suitable, these codes SHALL be taken from EvidenceVariableRole
                                              (extensible to http://hl7.org/fhir/ValueSet/variable-role)

                                              The role that the assertion variable plays.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              246. Evidence.variableDefinition:outcome.variableRole.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
                                              Typeid
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              248. Evidence.variableDefinition:outcome.variableRole.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())
                                              SlicingThis element introduces a set of slices on Evidence.variableDefinition.variableRole.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 250. Evidence.variableDefinition:outcome.variableRole.coding
                                                Definition

                                                A reference to a code defined by a terminology system.

                                                ShortCode defined by a terminology system
                                                Comments

                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                Control0..*
                                                TypeCoding
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                252. Evidence.variableDefinition:outcome.variableRole.text
                                                Definition

                                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                ShortPlain text representation of the concept
                                                Comments

                                                Very often the text is the same as a displayName of one of the codings.

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

                                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                Pattern ValueUse extension:variableRoleCode instead.
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                254. Evidence.variableDefinition:outcome.observed
                                                Definition

                                                Definition of the actual variable related to the statistic(s).

                                                ShortDefinition of the actual variable related to the statistic(s)
                                                Control0..1
                                                TypeReference(VariableDefinition)
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                256. Evidence.variableDefinition:outcome.intended
                                                Definition

                                                Definition of the intended variable related to the Evidence.

                                                ShortDefinition of the intended variable related to the Evidence
                                                Control0..1
                                                TypeReference(EvidenceVariable)
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                258. Evidence.variableDefinition:outcome.directnessMatch
                                                Definition

                                                Indication of quality of match between intended variable to actual variable.

                                                Shortlow | moderate | high | exact
                                                Control0..1
                                                BindingUnless not suitable, these codes SHALL be taken from EvidenceDirectness
                                                (extensible to http://terminology.hl7.org/ValueSet/directness)

                                                The quality of how direct the match is.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                260. Evidence.synthesisType
                                                Definition

                                                The method to combine studies.

                                                ShortThe method to combine studies
                                                Control0..1
                                                BindingUnless not suitable, these codes SHALL be taken from StatisticSynthesisType
                                                (extensible to http://terminology.hl7.org/ValueSet/synthesis-type)

                                                Types of combining results from a body of evidence (e.g. summary data meta-analysis).

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                262. Evidence.studyDesign
                                                Definition

                                                The design of the study that produced this evidence. The design is described with any number of study design characteristics.

                                                ShortThe design of the study that produced this evidence
                                                Control0..*
                                                BindingUnless not suitable, these codes SHALL be taken from StudyDesign
                                                (extensible to http://hl7.org/fhir/ValueSet/study-design)

                                                This is a set of terms for study design characteristics.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                264. Evidence.statistic
                                                Definition

                                                Values and parameters for a single statistic.

                                                ShortValues and parameters for a single statistic
                                                Control0..*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                266. Evidence.statistic.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
                                                268. Evidence.statistic.extension
                                                Definition

                                                An Extension

                                                ShortExtension
                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                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 Evidence.statistic.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 270. Evidence.statistic.extension:modelExpression
                                                  Slice NamemodelExpression
                                                  Definition

                                                  The formula for analysis.

                                                  ShortThe formula for analysis
                                                  Control0..1
                                                  TypeExtension(StatisticModelExpression) (Extension Type: Expression)
                                                  Is Modifierfalse
                                                  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())
                                                  272. Evidence.statistic.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())
                                                  274. Evidence.statistic.description
                                                  Definition

                                                  A description of the content value of the statistic.

                                                  ShortDescription of 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()))
                                                  276. Evidence.statistic.note
                                                  Definition

                                                  Footnotes and/or explanatory notes.

                                                  ShortFootnotes and/or explanatory notes
                                                  Control0..*
                                                  TypeAnnotation
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  278. Evidence.statistic.statisticType
                                                  Definition

                                                  Type of statistic, e.g., relative risk.

                                                  ShortType of statistic, e.g., relative risk
                                                  Control0..1
                                                  BindingUnless not suitable, these codes SHALL be taken from StatisticType
                                                  (extensible to http://hl7.org/fhir/ValueSet/statistic-type)
                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  280. Evidence.statistic.category
                                                  Definition

                                                  When the measured variable is handled categorically, the category element is used to define which category the statistic is reporting.

                                                  ShortAssociated category for categorical variable
                                                  Comments

                                                  Simple strings can be used for descriptive purposes. Exact matching to EvidenceVariable.category.name for the Evidence.variableDefinition[variableRole=measuredVariable].observed=Reference(EvidenceVariable) could facilitate validation within datasets.

                                                  Control0..1
                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  282. Evidence.statistic.quantity
                                                  Definition

                                                  Statistic value.

                                                  ShortStatistic value
                                                  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()))
                                                  284. Evidence.statistic.numberOfEvents
                                                  Definition

                                                  The number of events associated with the statistic, where the unit of analysis is different from numberAffected, sampleSize.knownDataCount and sampleSize.numberOfParticipants.

                                                  ShortThe number of events associated with the statistic
                                                  Comments

                                                  When the number of events is the statistic, use Evidence.statistic.quantity and set Evidence.statistic.type.coding.code=C25463 and Evidence.statistic.type.coding.display=Count. When the statistic is an Event Rate (where individual participants may have 2 or more events), use Evidence.statistic.numberOfEvents to record the total number of events rather than the number of participants with events.

                                                  Control0..1
                                                  TypeunsignedInt
                                                  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()))
                                                  286. Evidence.statistic.numberAffected
                                                  Definition

                                                  The number of participants affected where the unit of analysis is the same as sampleSize.knownDataCount and sampleSize.numberOfParticipants.

                                                  ShortThe number of participants affected
                                                  Comments

                                                  When the number affected is the statistic, use Evidence.statistic.quantity and set Evidence.statistic.type.coding.code=C25463 and Evidence.statistic.type.coding.display=Count. When the statistic is a Proportion, use Evidence.statistic.numberAffected and enter an integer as the value. When the statistic is an Event Rate (where individual participants may have 2 or more events), use Evidence.statistic.numberAffected to record the number of participants with events rather than the total number of events.

                                                  Control0..1
                                                  TypeunsignedInt
                                                  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()))
                                                  288. Evidence.statistic.sampleSize
                                                  Definition

                                                  Number of samples in the statistic.

                                                  ShortNumber of samples in the statistic
                                                  Control0..1
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  290. Evidence.statistic.sampleSize.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
                                                  292. Evidence.statistic.sampleSize.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())
                                                  294. Evidence.statistic.sampleSize.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())
                                                  296. Evidence.statistic.sampleSize.description
                                                  Definition

                                                  Human-readable summary of population sample size.

                                                  ShortTextual description of sample size for statistic
                                                  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()))
                                                  298. Evidence.statistic.sampleSize.note
                                                  Definition

                                                  Footnote or explanatory note about the sample size.

                                                  ShortFootnote or explanatory note about the sample size
                                                  Control0..*
                                                  TypeAnnotation
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  300. Evidence.statistic.sampleSize.numberOfStudies
                                                  Definition

                                                  Number of participants in the population.

                                                  ShortNumber of contributing studies
                                                  Control0..1
                                                  TypeunsignedInt
                                                  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()))
                                                  302. Evidence.statistic.sampleSize.numberOfParticipants
                                                  Definition

                                                  A human-readable string to clarify or explain concepts about the sample size.

                                                  ShortCumulative number of participants
                                                  Control0..1
                                                  TypeunsignedInt
                                                  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()))
                                                  304. Evidence.statistic.sampleSize.knownDataCount
                                                  Definition

                                                  Number of participants with known results for measured variables.

                                                  ShortNumber of participants with known results for measured variables
                                                  Control0..1
                                                  TypeunsignedInt
                                                  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()))
                                                  306. Evidence.statistic.attributeEstimate
                                                  Definition

                                                  A statistical attribute of the statistic such as a measure of heterogeneity.

                                                  ShortAn attribute of the Statistic
                                                  Control0..*
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  308. Evidence.statistic.attributeEstimate.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
                                                  310. Evidence.statistic.attributeEstimate.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())
                                                  312. Evidence.statistic.attributeEstimate.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())
                                                  314. Evidence.statistic.attributeEstimate.description
                                                  Definition

                                                  Human-readable summary of the estimate.

                                                  ShortTextual description of the attribute estimate
                                                  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()))
                                                  316. Evidence.statistic.attributeEstimate.note
                                                  Definition

                                                  Footnote or explanatory note about the estimate.

                                                  ShortFootnote or explanatory note about the estimate
                                                  Control0..*
                                                  TypeAnnotation
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  318. Evidence.statistic.attributeEstimate.type
                                                  Definition

                                                  The type of attribute estimate, e.g., confidence interval or p value.

                                                  ShortThe type of attribute estimate, e.g., confidence interval or p value
                                                  Control0..1
                                                  BindingUnless not suitable, these codes SHALL be taken from AttributeEstimateType
                                                  (extensible to http://hl7.org/fhir/ValueSet/attribute-estimate-type)
                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  320. Evidence.statistic.attributeEstimate.quantity
                                                  Definition

                                                  The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure.

                                                  ShortThe singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure
                                                  Comments

                                                  Often the p value

                                                  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()))
                                                  322. Evidence.statistic.attributeEstimate.level
                                                  Definition

                                                  Use 95 for a 95% confidence interval.

                                                  ShortLevel of confidence interval, e.g., 0.95 for 95% confidence interval
                                                  Control0..1
                                                  Typedecimal
                                                  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()))
                                                  324. Evidence.statistic.attributeEstimate.range
                                                  Definition

                                                  Lower bound of confidence interval.

                                                  ShortLower and upper bound values of the attribute estimate
                                                  Control0..1
                                                  TypeRange
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  326. Evidence.statistic.attributeEstimate.attributeEstimate
                                                  Definition

                                                  A nested attribute estimate; which is the attribute estimate of an attribute estimate.

                                                  ShortA nested attribute estimate; which is the attribute estimate of an attribute estimate
                                                  Comments

                                                  A nested attribute estimate; which is the attribute estimate of an attribute estimate

                                                  Control0..*
                                                  TypeSee ttp://hl7.org/fhir/StructureDefinition/Evidence#Evidence.statistic.attributeEstimate
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  328. Evidence.statistic.modelCharacteristic
                                                  Definition

                                                  A component of the method to generate the statistic.

                                                  ShortAn aspect of the statistical model
                                                  Control0..*
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  330. Evidence.statistic.modelCharacteristic.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
                                                  332. Evidence.statistic.modelCharacteristic.extension
                                                  Definition

                                                  An Extension

                                                  ShortExtension
                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  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 Evidence.statistic.modelCharacteristic.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 334. Evidence.statistic.modelCharacteristic.extension:valueQuantity
                                                    Slice NamevalueQuantity
                                                    Definition

                                                    The specific value (when paired with code) as a Quantity

                                                    ShortValue as Quantity
                                                    Control0..1
                                                    TypeExtension(StatisticModelValueQuantity) (Extension Type: Quantity(SimpleQuantity))
                                                    Is Modifierfalse
                                                    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())
                                                    336. Evidence.statistic.modelCharacteristic.extension:valueRange
                                                    Slice NamevalueRange
                                                    Definition

                                                    The specific value (when paired with code) as a Range

                                                    ShortValue as Range
                                                    Control0..1
                                                    TypeExtension(StatisticModelValueRange) (Extension Type: Range)
                                                    Is Modifierfalse
                                                    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())
                                                    338. Evidence.statistic.modelCharacteristic.extension:valueCodeableConcept
                                                    Slice NamevalueCodeableConcept
                                                    Definition

                                                    The specific value (when paired with code) as a CodeableConcept

                                                    ShortValue as CodeableConcept
                                                    Control0..1
                                                    TypeExtension(StatisticModelValueCodeableConcept) (Extension Type: CodeableConcept)
                                                    Is Modifierfalse
                                                    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())
                                                    340. Evidence.statistic.modelCharacteristic.extension:intended
                                                    Slice Nameintended
                                                    Definition

                                                    The plan for analysis.

                                                    ShortThe plan for analysis
                                                    Control0..1
                                                    TypeExtension(StatisticModelIntended) (Extension Type: boolean)
                                                    Is Modifierfalse
                                                    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())
                                                    342. Evidence.statistic.modelCharacteristic.extension:applied
                                                    Slice Nameapplied
                                                    Definition

                                                    The analysis that was applied.

                                                    ShortThe analysis that was applied
                                                    Control0..1
                                                    TypeExtension(StatisticModelApplied) (Extension Type: boolean)
                                                    Is Modifierfalse
                                                    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())
                                                    344. Evidence.statistic.modelCharacteristic.extension:includeIf
                                                    Slice NameincludeIf
                                                    Definition

                                                    The condition upon which to include the variable or model characteristic in the analysis.

                                                    ShortCondition upon which to include the variable or model characteristic in the analysis
                                                    Control0..1
                                                    TypeExtension(StatisticModelIncludeIf) (Complex Extension)
                                                    Is Modifierfalse
                                                    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())
                                                    346. Evidence.statistic.modelCharacteristic.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())
                                                    348. Evidence.statistic.modelCharacteristic.code
                                                    Definition

                                                    Description of a component of the method to generate the statistic.

                                                    ShortModel specification
                                                    Control1..1
                                                    BindingUnless not suitable, these codes SHALL be taken from StatisticModelCode
                                                    (extensible to http://hl7.org/fhir/ValueSet/statistic-model-code)
                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    350. Evidence.statistic.modelCharacteristic.value
                                                    Definition

                                                    Further specification of the quantified value of the component of the method to generate the statistic.

                                                    ShortNumerical value to complete model specification
                                                    Control0..0
                                                    TypeQuantity(SimpleQuantity)
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    352. Evidence.statistic.modelCharacteristic.variable
                                                    Definition

                                                    A variable adjusted for in the adjusted analysis.

                                                    ShortA variable adjusted for in the adjusted analysis
                                                    Control0..*
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    354. Evidence.statistic.modelCharacteristic.variable.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
                                                    356. Evidence.statistic.modelCharacteristic.variable.extension
                                                    Definition

                                                    An Extension

                                                    ShortExtension
                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    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 Evidence.statistic.modelCharacteristic.variable.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 358. Evidence.statistic.modelCharacteristic.variable.extension:includeIf
                                                      Slice NameincludeIf
                                                      Definition

                                                      The condition upon which to include the variable or model characteristic in the analysis.

                                                      ShortCondition upon which to include the variable or model characteristic in the analysis
                                                      Control0..1
                                                      TypeExtension(StatisticModelIncludeIf) (Complex Extension)
                                                      Is Modifierfalse
                                                      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())
                                                      360. Evidence.statistic.modelCharacteristic.variable.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())
                                                      362. Evidence.statistic.modelCharacteristic.variable.variableDefinition
                                                      Definition

                                                      Description of the variable.

                                                      ShortDescription of the variable
                                                      Control1..1
                                                      TypeReference(Group, EvidenceVariable)
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      364. Evidence.statistic.modelCharacteristic.variable.handling
                                                      Definition

                                                      How the variable is classified for use in adjusted analysis.

                                                      Shortcontinuous | dichotomous | ordinal | polychotomous
                                                      Control0..1
                                                      BindingThe codes SHALL be taken from EvidenceVariableHandling
                                                      (required to http://hl7.org/fhir/ValueSet/variable-handling|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()))
                                                      366. Evidence.statistic.modelCharacteristic.variable.valueCategory
                                                      Definition

                                                      Description for grouping of ordinal or polychotomous variables.

                                                      ShortDescription for grouping of ordinal or polychotomous variables
                                                      Control0..*
                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      368. Evidence.statistic.modelCharacteristic.variable.valueQuantity
                                                      Definition

                                                      Discrete value for grouping of ordinal or polychotomous variables.

                                                      ShortDiscrete value for grouping of ordinal or polychotomous variables
                                                      Control0..*
                                                      TypeQuantity
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      370. Evidence.statistic.modelCharacteristic.variable.valueRange
                                                      Definition

                                                      Range of values for grouping of ordinal or polychotomous variables.

                                                      ShortRange of values for grouping of ordinal or polychotomous variables
                                                      Control0..*
                                                      TypeRange
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      372. Evidence.statistic.modelCharacteristic.attributeEstimate
                                                      Definition

                                                      An attribute of the statistic used as a model characteristic.

                                                      ShortAn attribute of the statistic used as a model characteristic
                                                      Control0..*
                                                      TypeSee ttp://hl7.org/fhir/StructureDefinition/Evidence#Evidence.statistic.attributeEstimate
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      374. Evidence.certainty
                                                      Definition

                                                      Assessment of certainty, confidence in the estimates, or quality of the evidence.

                                                      ShortCertainty or quality of the evidence
                                                      Control0..*
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      376. Evidence.certainty.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
                                                      378. Evidence.certainty.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())
                                                      380. Evidence.certainty.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())
                                                      382. Evidence.certainty.description
                                                      Definition

                                                      Textual description of certainty.

                                                      ShortTextual description of certainty
                                                      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()))
                                                      384. Evidence.certainty.note
                                                      Definition

                                                      Footnotes and/or explanatory notes.

                                                      ShortFootnotes and/or explanatory notes
                                                      Control0..*
                                                      TypeAnnotation
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      386. Evidence.certainty.type
                                                      Definition

                                                      Aspect of certainty being rated.

                                                      ShortAspect of certainty being rated
                                                      Control0..1
                                                      BindingUnless not suitable, these codes SHALL be taken from EvidenceCertaintyType
                                                      (extensible to http://hl7.org/fhir/ValueSet/certainty-type)

                                                      The aspect of quality, confidence, or certainty.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      388. Evidence.certainty.rating
                                                      Definition

                                                      Assessment or judgement of the aspect.

                                                      ShortAssessment or judgement of the aspect
                                                      Control0..1
                                                      BindingUnless not suitable, these codes SHALL be taken from EvidenceCertaintyRating
                                                      (extensible to http://hl7.org/fhir/ValueSet/certainty-rating)

                                                      The assessment of quality, confidence, or certainty.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      390. Evidence.certainty.rater
                                                      Definition

                                                      Individual or group who did the rating.

                                                      ShortIndividual or group who did the rating
                                                      Control0..1
                                                      Typestring
                                                      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()))
                                                      392. Evidence.certainty.subcomponent
                                                      Definition

                                                      A domain or subdomain of certainty.

                                                      ShortA domain or subdomain of certainty
                                                      Control0..*
                                                      TypeSee ttp://hl7.org/fhir/StructureDefinition/Evidence#Evidence.certainty
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))