FHIR CI-Build

This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions icon

14.12 Resource Evidence - Content

Clinical Decision Support icon Work GroupMaturity Level: 1 Trial UseSecurity Category: Business Compartments: No defined compartments

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.

14.12.1 Scope and Usage

The Evidence Resource enables the expression of the most granular form of evidence, such as the actual quantitative results of a study or scientific analysis.

Human-readable summaries of the Evidence Resource may be expressed in description, assertion, and note elements. The description element is typically used for the primary expression. The assertion element is less commonly used and is typically used for interpretive expression. The note element may be used for any number of explanatory, variant, or related comments.

The variableDefinition element is used to describe what the evidence is about. Each variable defined must be assigned a variable role which signals how that variable is used in the statistics within the Evidence Resource. The variable definition may be expressed in human-readable form (with a description element) and/or expressed in computable form by referencing Group or EvidenceVariable Resources. In general, Group Resources are used to define populations and EvidenceVariable Resources are used to define measured variables (exposures, outcomes, and covariates). The variableDefinition element allows expression of the observed variable and the intended variable. In many forms of expression the Evidence is interpreted for a specific context and recognition of both observed and intended variables is important for understanding the applicability and certainty of the evidence.

The heart of the evidence is the statistic. The statistic BackboneElement provides a machine-interpretable expression of a statistic, including the quantity; unit of measure; classification of statistic type; sample size; attributes such as confidence intervals, p values, and heterogeneity estimates; and statistic model characteristics. An Evidence Resource may contain more than one statistic, in which case each statistic matches the same combination of variable definitions.

Because a statistic can rarely be interpreted without knowing how it was obtained, the Evidence Resource enables expression of the studyDesign. For evidence derived from synthesis of evidence, the Evidence Resource enables expression of the synthesisType.

The certainty element provides a machine-interpretable expression of certainty, confidence or quality of the resource in which it is included. The certainty element can express overall certainty and certainty of any subcomponent concepts using codeable concepts from structured rating systems. The certainty element enables machine-to-machine communication of the certainty of evidence.

14.12.2 Boundaries and Relationships

The Evidence Resource is the central atomic component for the Evidence-related Resources. The Evidence Resource may reference multiple Group and EvidenceVariable Resources; in these cases, the Group and EvidenceVariable Resources to which an Evidence Resource points does not refer back to the Evidence. In the context of evidence synthesis, a List Resource may reference Evidence Resources where the List Resource is used to define the set of evidence being synthesized.

14.12.3 References to this Resource

14.12.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Evidence TU DomainResource Single evidence bit
+ Warning: Name should be usable as an identifier for the module by machine processing applications such as code generation

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
Interfaces Implemented: MetadataResource
... url ΣC 0..1 uri Canonical identifier for this evidence, represented as a globally unique URI
+ Warning: URL should not contain | or # - these characters make processing canonical references problematic
... identifier Σ 0..* Identifier Additional identifier for the summary

... version Σ 0..1 string Business version of this summary
... versionAlgorithm[x] Σ 0..1 How to compare versions
Binding: Version Algorithm (Extensible)
.... versionAlgorithmString string
.... versionAlgorithmCoding Coding
... name C 0..1 string Name for this summary (machine friendly)
... title ΣT 0..1 string Name for this summary (human friendly)
... citeAs 0..1 markdown Display of how to cite this Evidence
... status ?!Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (Required)
... experimental 0..1 boolean For testing only - never for real usage
... date Σ 0..1 dateTime Date last changed
... approvalDate 0..1 date When the summary was approved by publisher
... lastReviewDate 0..1 date When the summary was last reviewed by the publisher
... author Σ 0..* ContactDetail Who authored the content

... publisher ΣT 0..1 string Name of the publisher/steward (organization or individual)
... contact Σ 0..* ContactDetail Contact details for the publisher

... recorder 0..* ContactDetail Who entered the data for the evidence

... editor 0..* ContactDetail Who edited the content

... reviewer 0..* ContactDetail Who reviewed the content

... endorser 0..* ContactDetail Who endorsed the content

... useContext Σ 0..* UsageContext The context that the content is intended to support

... purpose 0..1 markdown Why this Evidence is defined
... copyright 0..1 markdown Intellectual property ownership, may include restrictions on use
... copyrightLabel T 0..1 string Copyright holder and year(s)
... relatesTo 0..* BackboneElement Relationships to other Resources

.... type 1..1 code documentation | justification | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | specification-of | created-with | cite-as | summarizes
Binding: Artifact Relationship Type (Required)
.... target[x] 1..1 The artifact that is related to this Evidence
..... targetUri uri
..... targetAttachment Attachment
..... targetCanonical canonical(Any)
..... targetReference Reference(Any)
..... targetMarkdown markdown
... description ΣT 0..1 markdown Description of the particular summary
... assertion T 0..1 markdown Declarative description of the Evidence
... note 0..* Annotation Footnotes and/or explanatory notes

... variableDefinition 0..* BackboneElement Description, classification, and definition of a single variable

.... description 0..1 markdown A text description or summary of the variable
.... note 0..* Annotation Footnotes and/or explanatory notes

.... variableRole Σ 1..1 code population | exposure | outcome | covariate
Binding: Evidence Variable Role (Required)
.... roleSubtype 0..1 CodeableConcept Sub-classification of the role of the variable
Binding: Evidence Variable Role Subtype (Extensible)
.... comparatorCategory 0..1 string The reference value used for comparison
.... observed Σ 0..1 Reference(Group | EvidenceVariable) Definition of the actual variable related to the statistic(s)
.... intended 0..1 Reference(Group | EvidenceVariable) Definition of the intended variable related to the Evidence
.... directnessMatch 0..1 CodeableConcept low | moderate | high | exact
Binding: EvidenceDirectness icon (Extensible)
... synthesisType 0..* CodeableConcept The design of the synthesis (combination of studies) that produced this evidence
Binding: StatisticSynthesisType icon (Extensible)

... studyDesign 0..* CodeableConcept The design of the study that produced this evidence
Binding: Study Design (Extensible)

... statistic 0..* BackboneElement Values and parameters for a single statistic

.... description 0..1 markdown A natural language summary of the statistic
.... note 0..* Annotation Footnotes and/or explanatory notes

.... statisticType Σ 0..1 CodeableConcept Type of statistic, e.g., relative risk
Binding: Statistic Type (Extensible)
.... category 0..1 CodeableConcept Associated category for categorical variable
.... quantity Σ 0..1 Quantity Statistic value
.... numberOfEvents 0..1 unsignedInt The number of events associated with the statistic
.... numberAffected 0..1 unsignedInt The number of participants affected
.... sampleSize 0..1 BackboneElement Count of participants in the study sample
..... description 0..1 markdown Textual description of sample size for statistic
..... note 0..* Annotation Footnote or explanatory note about the sample size

..... numberOfStudies 0..1 unsignedInt Number of contributing studies
..... numberOfParticipants 0..1 unsignedInt Total number of participants
..... knownDataCount 0..1 unsignedInt Number of participants with known results for measured variables
.... attributeEstimate 0..* BackboneElement An attribute of the Statistic

..... description 0..1 markdown Textual description of the attribute estimate
..... note 0..* Annotation Footnote or explanatory note about the estimate

..... type 0..1 CodeableConcept The type of attribute estimate, e.g., confidence interval or p value
Binding: Attribute Estimate Type (Extensible)
..... quantity 0..1 Quantity The singular quantity of the attribute estimate, for attribute estimates represented as single values, which may include a unit of measure
..... level 0..1 decimal Level of confidence interval, e.g., 0.95 for 95% confidence interval
..... range 0..1 Range Lower and upper bound values of the attribute estimate
..... attributeEstimate 0..* see attributeEstimate A nested attribute estimate; which is the attribute estimate of an attribute estimate

.... modelCharacteristic 0..* BackboneElement An aspect of the statistical model

..... code 1..1 CodeableConcept Model specification
Binding: Statistic Model Code (Extensible)
..... value[x] 0..1 The specific value (when paired with code)
...... valueQuantity SimpleQuantity
...... valueRange Range
...... valueCodeableConcept CodeableConcept
..... intended 0..1 boolean The plan for analysis
..... applied 0..1 boolean This model characteristic is part of the analysis that was applied, whether or not the analysis followed the plan
..... variable 0..* BackboneElement A variable adjusted for in the adjusted analysis

...... variableDefinition 1..1 Reference(Group | EvidenceVariable) Description and definition of the variable
...... handling 0..1 code boolean | continuous | dichotomous | ordinal | polychotomous | extension
Binding: Evidence Variable Handling (Required)
...... valueCategory 0..* CodeableConcept Qualitative label used for grouping values of a dichotomous, ordinal, or polychotomous variable

...... valueQuantity 0..* Quantity Quantitative label used for grouping values of a dichotomous, ordinal, or polychotomous variable

...... valueRange 0..* Range Range of quantitative labels used for grouping values of a dichotomous, ordinal, or polychotomous variable

..... attribute 0..* see attributeEstimate An attribute of the model characteristic

... certainty 0..* BackboneElement Certainty or quality of the evidence

.... description 0..1 markdown Textual description of certainty
.... note 0..* Annotation Footnotes and/or explanatory notes

.... type 0..1 CodeableConcept Aspect of certainty being rated
Binding: Evidence Certainty Type (Extensible)
.... rating 0..1 CodeableConcept Assessment or judgement of the aspect
Binding: Evidence Certainty Rating (Extensible)
.... rater 0..* string Individual or group who did the rating

.... subcomponent 0..* see certainty A domain or subdomain of certainty


doco Documentation for this format icon

See the Extensions for this resource

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) , the spreadsheet version & the dependency analysis

14.12.4.1 Terminology Bindings

Path ValueSet Type Documentation
Evidence.versionAlgorithm[x] VersionAlgorithm Extensible

Indicates the mechanism used to compare versions to determine which is more current.
Evidence.status PublicationStatus Required

The lifecycle status of an artifact.
Evidence.relatesTo.type ArtifactRelationshipType Required

Type of relationship to the related artifact.
Evidence.variableDefinition.variableRole EvidenceVariableRole (a valid code from VariableRole) Required

The role that the variable plays.
Evidence.variableDefinition.roleSubtype EvidenceVariableRoleSubtype (a valid code from EvidenceVariableRole icon) Extensible

The sub-role that the variable plays.
Evidence.variableDefinition.directnessMatch EvidenceDirectness icon Extensible

The quality of how direct the match is.
Evidence.synthesisType StatisticSynthesisType icon Extensible

Types of combining results from a body of evidence (eg. summary data meta-analysis).
Evidence.studyDesign StudyDesign Extensible

This is a set of terms for study design characteristics.
Evidence.statistic.statisticType StatisticType (a valid code from StatisticStatisticType icon) Extensible

The type of a statistic, e.g. relative risk or mean
Evidence.statistic.attributeEstimate.type AttributeEstimateType (a valid code from StatisticAttribute Estimate Type icon) Extensible

A statistic about a statistic, e.g. Confidence interval or p-value
Evidence.statistic.modelCharacteristic.code StatisticModelCode Extensible

The handling of the variable in statistical analysis for exposures or outcomes.
Evidence.statistic.modelCharacteristic.variable.handling EvidenceVariableHandling Required

The handling of the variable in statistical analysis for exposures or outcomes (E.g. Dichotomous, Continuous, Descriptive).
Evidence.certainty.type EvidenceCertaintyType Extensible

The aspect of quality, confidence, or certainty.
Evidence.certainty.rating EvidenceCertaintyRating Extensible

The assessment of quality, confidence, or certainty.

14.12.4.2 Constraints

UniqueKeyLevelLocationDescriptionExpression
img cnl-0Warning (base)Name should be usable as an identifier for the module by machine processing applications such as code generationname.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$')
img cnl-1Warning Evidence.urlURL should not contain | or # - these characters make processing canonical references problematicexists() implies matches('^[^|# ]+$')



14.12.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
context token A use context assigned to the evidence (Evidence.useContext.value.ofType(CodeableConcept)) 30 Resources
context-quantity quantity A quantity- or range-valued use context assigned to the evidence (Evidence.useContext.value.ofType(Quantity)) | (Evidence.useContext.value.ofType(Range)) 30 Resources
context-type token A type of use context assigned to the evidence Evidence.useContext.code 30 Resources
context-type-quantity composite A use context type and quantity- or range-based value assigned to the evidence On Evidence.useContext:
  context-type: code
  context-quantity: value.ofType(Quantity) | value.ofType(Range)		 30 Resources
context-type-value composite A use context type and value assigned to the evidence On Evidence.useContext:
  context-type: code
  context: value.ofType(CodeableConcept)		 30 Resources
date date The evidence publication date Evidence.date 31 Resources
description string The description of the evidence Evidence.description 29 Resources
identifier token External identifier for the evidence Evidence.identifier 35 Resources
publisher string Name of the publisher of the evidence Evidence.publisher 31 Resources
status token The current status of the evidence Evidence.status 35 Resources
title string The human-friendly name of the evidence Evidence.title 28 Resources
url uri The uri that identifies the evidence Evidence.url 34 Resources
version token The business version of the evidence Evidence.version 32 Resources