Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot2 - STU 1 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-ballot2 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: Comparison - Detailed Descriptions

Page standards status: Draft Maturity Level: 1

Definitions for the comparison resource profile.

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

0. ArtifactAssessment
Definition

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

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

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

ShortA set of rules under which this content was created
Comments

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

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

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

ShortContained, inline Resources
Comments

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

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

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

ShortCanonical identifier for this artifact, represented as a URI (globally unique)
Comments

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

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

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

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

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

ShortNatural language description of the artifact
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 artifact 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 artifact is presumed to be the predominant language in the place the artifact was created).

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

An individual or organization primarily involved in the creation and maintenance of the artifact.

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

The artifact being compared to the referenced artifact.

ShortThe artifact being compared to the referenced artifact
Control0..*
TypeExtension(ArtifactAssessmentCompared) (Extension Type: Choice of: canonical, uri, Reference)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. ArtifactAssessment.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored
Comments

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

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

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

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. ArtifactAssessment.identifier
Definition

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


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

ShortAdditional identifier for the ComparisonAdditional identifier for the artifact assessment
Comments

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


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

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

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


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

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

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


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

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

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


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

ShortDate last changed
Comments

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

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

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


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

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

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


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

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

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

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

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

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

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

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

If specified, this date follows the original approval date.

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

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

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

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


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

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

Indicates the workflow status of the comparison and adaptation process.


Indicates the workflow status of the comment or change request.

ShortThe workflow status of the comparison and adaptation processsubmitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published | entered-in-error
Control0..1
BindingThe codes SHALL be taken from ArtifactAssessmentWorkflowStatushttp://hl7.org/fhir/ValueSet/artifactassessment-workflow-status|6.0.0-ballot2
(required to http://hl7.org/fhir/ValueSet/artifactassessment-workflow-status|6.0.0-ballot2)
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. ArtifactAssessment.disposition
Definition

Indicates the disposition of the responsible party for approval of the comparison and adaptation.


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

ShortThe disposition of the proposed adaptationunresolved | not-persuasive | persuasive | persuasive-with-modification | not-persuasive-with-modification
Control0..1
BindingThe codes SHALL be taken from ArtifactAssessmentDispositionhttp://hl7.org/fhir/ValueSet/artifactassessment-disposition|6.0.0-ballot2
(required to http://hl7.org/fhir/ValueSet/artifactassessment-disposition|6.0.0-ballot2)
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))