Clinical Practice Guidelines (CPG) on EBMonFHIR
1.0.1 - ci-build

Clinical Practice Guidelines (CPG) on EBMonFHIR, published by Universitätsmedizin Greifswald. This guide is not an authorized publication; it is the continuous build for version 1.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/CEOsys/cpg-on-ebm-on-fhir/ and changes regularly. See the Directory of published versions

Resource Profile: RecommendationJustification - Detailed Descriptions

Draft as of 2022-03-04

Definitions for the recommendation-justification resource profile.

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

0. ArtifactAssessment
2. ArtifactAssessment.meta
Control1..?
Must Supporttrue
4. ArtifactAssessment.meta.source
Must Supporttrue
6. ArtifactAssessment.meta.profile
Control1..?
Must Supporttrue
8. ArtifactAssessment.extension
Control2..?
SlicingThis element introduces a set of slices on ArtifactAssessment.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 10. ArtifactAssessment.extension:version
    Slice Nameversion
    Control1..1
    TypeExtension(ArtifactAssessment Version) (Extension Type: string)
    Must Supporttrue
    12. ArtifactAssessment.extension:publicationStatus
    Slice NamepublicationStatus
    Control1..1
    TypeExtension(ArtifactAssessment Publication Status) (Extension Type: code)
    Must Supporttrue
    14. ArtifactAssessment.date
    Control1..?
    16. ArtifactAssessment.artifact[x]
    TypeReference(Recommendation Plan), canonical, uri
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    18. ArtifactAssessment.content
    Control2..?
    Must Supporttrue
    SlicingThis element introduces a set of slices on ArtifactAssessment.content. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • value @ type
    • 20. ArtifactAssessment.content:strength
      Slice Namestrength
      Control1..1
      Must Supporttrue
      22. ArtifactAssessment.content:strength.informationType
      Control1..?
      Pattern Valuerating
      24. ArtifactAssessment.content:strength.type
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
          "code" : "strength",
          "display" : "Strength of recommendation"
        }]
      }
      26. ArtifactAssessment.content:strength.classifier
      Control1..1
      BindingThe codes SHALL be taken from Recommendation Strength
      (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/ceosys-vs-recommendation-strength)
      28. ArtifactAssessment.content:consensus
      Slice Nameconsensus
      Control0..1
      Must Supporttrue
      30. ArtifactAssessment.content:consensus.informationType
      Control1..?
      Pattern Valuerating
      32. ArtifactAssessment.content:consensus.type
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
          "code" : "consensus",
          "display" : "Consensus"
        }]
      }
      34. ArtifactAssessment.content:consensus.classifier
      Control1..1
      BindingThe codes SHALL be taken from Rating Consensus
      (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-consensus)
      36. ArtifactAssessment.content:benefitAndHarms
      Slice NamebenefitAndHarms
      Control0..1
      Must Supporttrue
      38. ArtifactAssessment.content:benefitAndHarms.informationType
      Control1..?
      Pattern Valuerating
      40. ArtifactAssessment.content:benefitAndHarms.type
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
          "code" : "benefit-and-harms",
          "display" : "Benefit and harms"
        }]
      }
      42. ArtifactAssessment.content:benefitAndHarms.classifier
      Control1..1
      BindingThe codes SHALL be taken from Rating Benefit And Harms
      (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-benefit-and-harms)
      44. ArtifactAssessment.content:certaintyOfEvidence
      Slice NamecertaintyOfEvidence
      Control0..1
      Must Supporttrue
      46. ArtifactAssessment.content:certaintyOfEvidence.informationType
      Control1..?
      Pattern Valuerating
      48. ArtifactAssessment.content:certaintyOfEvidence.type
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://hl7.org/fhir/certainty-type",
          "code" : "Overall",
          "display" : "Overall certainty"
        }]
      }
      50. ArtifactAssessment.content:certaintyOfEvidence.classifier
      Control1..1
      BindingThe codes SHALL be taken from Rating Certainty Of Evidence
      (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-certainty-of-evidence)
      52. ArtifactAssessment.content:preferenceAndValues
      Slice NamepreferenceAndValues
      Control0..1
      Must Supporttrue
      54. ArtifactAssessment.content:preferenceAndValues.informationType
      Control1..?
      Pattern Valuerating
      56. ArtifactAssessment.content:preferenceAndValues.type
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
          "code" : "preference-and-values",
          "display" : "Preference and values"
        }]
      }
      58. ArtifactAssessment.content:preferenceAndValues.classifier
      Control1..1
      BindingThe codes SHALL be taken from Rating Preference And Values
      (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-preference-and-values)
      60. ArtifactAssessment.content:resources
      Slice Nameresources
      Control0..1
      Must Supporttrue
      62. ArtifactAssessment.content:resources.informationType
      Control1..?
      Pattern Valuerating
      64. ArtifactAssessment.content:resources.type
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
          "code" : "resources",
          "display" : "Resources"
        }]
      }
      66. ArtifactAssessment.content:resources.classifier
      Control1..1
      BindingThe codes SHALL be taken from Rating Resources
      (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-resources)
      68. ArtifactAssessment.content:equity
      Slice Nameequity
      Control0..1
      Must Supporttrue
      70. ArtifactAssessment.content:equity.informationType
      Control1..?
      Pattern Valuerating
      72. ArtifactAssessment.content:equity.type
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
          "code" : "equity",
          "display" : "Equity"
        }]
      }
      74. ArtifactAssessment.content:equity.classifier
      Control1..1
      BindingThe codes SHALL be taken from Rating Equity
      (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-equity)
      76. ArtifactAssessment.content:acceptability
      Slice Nameacceptability
      Control0..1
      Must Supporttrue
      78. ArtifactAssessment.content:acceptability.informationType
      Control1..?
      Pattern Valuerating
      80. ArtifactAssessment.content:acceptability.type
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
          "code" : "acceptability",
          "display" : "Acceptability"
        }]
      }
      82. ArtifactAssessment.content:acceptability.classifier
      Control1..1
      BindingThe codes SHALL be taken from Rating Acceptability
      (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-acceptability)
      84. ArtifactAssessment.content:feasibility
      Slice Namefeasibility
      Control0..1
      Must Supporttrue
      86. ArtifactAssessment.content:feasibility.informationType
      Control1..?
      Pattern Valuerating
      88. ArtifactAssessment.content:feasibility.type
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
          "code" : "feasibility",
          "display" : "Feasibility"
        }]
      }
      90. ArtifactAssessment.content:feasibility.classifier
      Control1..1
      BindingThe codes SHALL be taken from Rating Feasibility
      (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-feasibility)
      92. ArtifactAssessment.content:evidenceRating
      Slice NameevidenceRating
      Control0..*
      Must Supporttrue
      94. ArtifactAssessment.content:evidenceRating.informationType
      Control1..?
      Pattern Valuecontainer
      96. ArtifactAssessment.content:evidenceRating.type
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
          "code" : "certainty-of-evidence-rating",
          "display" : "Certainty of evidence rating"
        }]
      }
      98. ArtifactAssessment.content:evidenceRating.relatedArtifact
      Control1..1
      Must Supporttrue
      100. ArtifactAssessment.content:evidenceRating.relatedArtifact.type
      Pattern Valuejustification
      102. ArtifactAssessment.content:evidenceRating.relatedArtifact.classifier
      Control1..1
      Pattern Value{
        "coding" : [{
          "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
          "code" : "certainty-of-evidence-rating",
          "display" : "Certainty of evidence rating"
        }]
      }
      104. ArtifactAssessment.content:evidenceRating.relatedArtifact.resourceReference
      Control1..?
      TypeReference(Certainty of Evidence Rating)
      Must Supporttrue
      106. ArtifactAssessment.content:netEffect
      Slice NamenetEffect
      Control0..1
      108. ArtifactAssessment.content:netEffect.informationType
      Control1..?
      Pattern Valuecontainer
      110. ArtifactAssessment.content:netEffect.type
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
          "code" : "net-effect",
          "display" : "Net effect"
        }]
      }
      112. ArtifactAssessment.content:netEffect.relatedArtifact
      Control1..1
      Must Supporttrue
      114. ArtifactAssessment.content:netEffect.relatedArtifact.type
      Pattern Valuesupported-with
      116. ArtifactAssessment.content:netEffect.relatedArtifact.classifier
      Control1..1
      Pattern Value{
        "coding" : [{
          "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
          "code" : "net-effect",
          "display" : "Net effect"
        }]
      }
      118. ArtifactAssessment.content:netEffect.relatedArtifact.resourceReference
      Control1..?
      TypeReference(Net Effect Estimate)
      Must Supporttrue

      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.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
      Control10..1
      TypeMeta
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. ArtifactAssessment.meta.source
      Definition

      A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

      ShortIdentifies where the resource comes from
      Comments

      The exact use of the source (and the possible implied Provenance.entity.role and agent.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. The source may correspond to Provenance.entity.what[x] or Provenance.agent.who[x], though it may be a more general or abstract reference.

      This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

      Control0..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. ArtifactAssessment.meta.profile
      Definition

      A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

      ShortProfiles this resource claims to conform to
      Comments

      It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

      Control10..*
      Typecanonical(StructureDefinition)
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. 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()))
      10. 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
      12. ArtifactAssessment.extension
      Definition

      An Extension


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

      ShortExtensionAdditional content defined by implementations
      Comments

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

      Control20..*
      TypeExtension
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on ArtifactAssessment.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 14. ArtifactAssessment.extension:version
        Slice Nameversion
        Definition

        Extension used on Artifact Assessment resources to describe the guideline recommendation version.

        ShortVersion
        Control1..1
        TypeExtension(ArtifactAssessment Version) (Extension Type: string)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        16. ArtifactAssessment.extension:publicationStatus
        Slice NamepublicationStatus
        Definition

        Extension used on ArtifactAssessment resources to describe the guideline recommendation publication status.

        ShortPublication status
        Control1..1
        TypeExtension(ArtifactAssessment Publication Status) (Extension Type: code)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. ArtifactAssessment.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())
        20. ArtifactAssessment.date
        Definition

        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.

        Control10..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.artifact[x]
        Definition

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

        ShortThe artifact assessed, commented upon or rated
        Control1..1
        TypeReference(Recommendation Plan, Resource), canonical, uri
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. ArtifactAssessment.content
        Definition

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

        ShortComment, classifier, or rating content
        Control20..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        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 ArtifactAssessment.content. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • value @ type
        • 26. ArtifactAssessment.content.modifierExtension
          Definition

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

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

          ShortComment, classifier, or rating content
          Control10..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. ArtifactAssessment.content:strength.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())
          32. ArtifactAssessment.content:strength.informationType
          Definition

          The type of information this component of the content represents.

          Shortcomment | classifier | rating | container | response | change-request
          Control10..1
          BindingThe codes SHALL be taken from ArtifactAssessmentInformationTypehttp://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0
          (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Pattern Valuerating
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. ArtifactAssessment.content:strength.type
          Definition

          Indicates what type of content this component represents.

          ShortWhat type of content
          Control10..1
          BindingFor example codes, see EvidenceCertaintyTypehttp://hl7.org/fhir/ValueSet/certainty-type
          (example to http://hl7.org/fhir/ValueSet/certainty-type)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Pattern Value{
            "coding" : [{
              "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
              "code" : "strength",
              "display" : "Strength of recommendation"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. ArtifactAssessment.content:strength.classifier
          Definition

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

          ShortRating, classifier, or assessment
          Control10..1*
          BindingThe codes SHALL be taken from For example codes, see Recommendation Strengthhttp://hl7.org/fhir/ValueSet/certainty-rating
          (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/ceosys-vs-recommendation-strength)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. ArtifactAssessment.content:consensus
          Slice Nameconsensus
          Definition

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

          ShortComment, classifier, or rating content
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. ArtifactAssessment.content:consensus.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())
          42. ArtifactAssessment.content:consensus.informationType
          Definition

          The type of information this component of the content represents.

          Shortcomment | classifier | rating | container | response | change-request
          Control10..1
          BindingThe codes SHALL be taken from ArtifactAssessmentInformationTypehttp://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0
          (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Pattern Valuerating
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. ArtifactAssessment.content:consensus.type
          Definition

          Indicates what type of content this component represents.

          ShortWhat type of content
          Control10..1
          BindingFor example codes, see EvidenceCertaintyTypehttp://hl7.org/fhir/ValueSet/certainty-type
          (example to http://hl7.org/fhir/ValueSet/certainty-type)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Pattern Value{
            "coding" : [{
              "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
              "code" : "consensus",
              "display" : "Consensus"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. ArtifactAssessment.content:consensus.classifier
          Definition

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

          ShortRating, classifier, or assessment
          Control10..1*
          BindingThe codes SHALL be taken from For example codes, see Rating Consensushttp://hl7.org/fhir/ValueSet/certainty-rating
          (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-consensus)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. ArtifactAssessment.content:benefitAndHarms
          Slice NamebenefitAndHarms
          Definition

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

          ShortComment, classifier, or rating content
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. ArtifactAssessment.content:benefitAndHarms.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())
          52. ArtifactAssessment.content:benefitAndHarms.informationType
          Definition

          The type of information this component of the content represents.

          Shortcomment | classifier | rating | container | response | change-request
          Control10..1
          BindingThe codes SHALL be taken from ArtifactAssessmentInformationTypehttp://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0
          (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Pattern Valuerating
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. ArtifactAssessment.content:benefitAndHarms.type
          Definition

          Indicates what type of content this component represents.

          ShortWhat type of content
          Control10..1
          BindingFor example codes, see EvidenceCertaintyTypehttp://hl7.org/fhir/ValueSet/certainty-type
          (example to http://hl7.org/fhir/ValueSet/certainty-type)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Pattern Value{
            "coding" : [{
              "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
              "code" : "benefit-and-harms",
              "display" : "Benefit and harms"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. ArtifactAssessment.content:benefitAndHarms.classifier
          Definition

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

          ShortRating, classifier, or assessment
          Control10..1*
          BindingThe codes SHALL be taken from For example codes, see Rating Benefit And Harmshttp://hl7.org/fhir/ValueSet/certainty-rating
          (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-benefit-and-harms)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. ArtifactAssessment.content:certaintyOfEvidence
          Slice NamecertaintyOfEvidence
          Definition

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

          ShortComment, classifier, or rating content
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. ArtifactAssessment.content:certaintyOfEvidence.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())
          62. ArtifactAssessment.content:certaintyOfEvidence.informationType
          Definition

          The type of information this component of the content represents.

          Shortcomment | classifier | rating | container | response | change-request
          Control10..1
          BindingThe codes SHALL be taken from ArtifactAssessmentInformationTypehttp://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0
          (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Pattern Valuerating
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. ArtifactAssessment.content:certaintyOfEvidence.type
          Definition

          Indicates what type of content this component represents.

          ShortWhat type of content
          Control10..1
          BindingFor example codes, see EvidenceCertaintyTypehttp://hl7.org/fhir/ValueSet/certainty-type
          (example to http://hl7.org/fhir/ValueSet/certainty-type)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Pattern Value{
            "coding" : [{
              "system" : "http://hl7.org/fhir/certainty-type",
              "code" : "Overall",
              "display" : "Overall certainty"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. ArtifactAssessment.content:certaintyOfEvidence.classifier
          Definition

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

          ShortRating, classifier, or assessment
          Control10..1*
          BindingThe codes SHALL be taken from For example codes, see Rating Certainty Of Evidencehttp://hl7.org/fhir/ValueSet/certainty-rating
          (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-certainty-of-evidence)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. ArtifactAssessment.content:preferenceAndValues
          Slice NamepreferenceAndValues
          Definition

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

          ShortComment, classifier, or rating content
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. ArtifactAssessment.content:preferenceAndValues.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())
          72. ArtifactAssessment.content:preferenceAndValues.informationType
          Definition

          The type of information this component of the content represents.

          Shortcomment | classifier | rating | container | response | change-request
          Control10..1
          BindingThe codes SHALL be taken from ArtifactAssessmentInformationTypehttp://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0
          (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Pattern Valuerating
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. ArtifactAssessment.content:preferenceAndValues.type
          Definition

          Indicates what type of content this component represents.

          ShortWhat type of content
          Control10..1
          BindingFor example codes, see EvidenceCertaintyTypehttp://hl7.org/fhir/ValueSet/certainty-type
          (example to http://hl7.org/fhir/ValueSet/certainty-type)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Pattern Value{
            "coding" : [{
              "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
              "code" : "preference-and-values",
              "display" : "Preference and values"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          76. ArtifactAssessment.content:preferenceAndValues.classifier
          Definition

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

          ShortRating, classifier, or assessment
          Control10..1*
          BindingThe codes SHALL be taken from For example codes, see Rating Preference And Valueshttp://hl7.org/fhir/ValueSet/certainty-rating
          (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-preference-and-values)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          78. ArtifactAssessment.content:resources
          Slice Nameresources
          Definition

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

          ShortComment, classifier, or rating content
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. ArtifactAssessment.content:resources.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())
          82. ArtifactAssessment.content:resources.informationType
          Definition

          The type of information this component of the content represents.

          Shortcomment | classifier | rating | container | response | change-request
          Control10..1
          BindingThe codes SHALL be taken from ArtifactAssessmentInformationTypehttp://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0
          (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Pattern Valuerating
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          84. ArtifactAssessment.content:resources.type
          Definition

          Indicates what type of content this component represents.

          ShortWhat type of content
          Control10..1
          BindingFor example codes, see EvidenceCertaintyTypehttp://hl7.org/fhir/ValueSet/certainty-type
          (example to http://hl7.org/fhir/ValueSet/certainty-type)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Pattern Value{
            "coding" : [{
              "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
              "code" : "resources",
              "display" : "Resources"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          86. ArtifactAssessment.content:resources.classifier
          Definition

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

          ShortRating, classifier, or assessment
          Control10..1*
          BindingThe codes SHALL be taken from For example codes, see Rating Resourceshttp://hl7.org/fhir/ValueSet/certainty-rating
          (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-resources)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          88. ArtifactAssessment.content:equity
          Slice Nameequity
          Definition

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

          ShortComment, classifier, or rating content
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          90. ArtifactAssessment.content:equity.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())
          92. ArtifactAssessment.content:equity.informationType
          Definition

          The type of information this component of the content represents.

          Shortcomment | classifier | rating | container | response | change-request
          Control10..1
          BindingThe codes SHALL be taken from ArtifactAssessmentInformationTypehttp://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0
          (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Pattern Valuerating
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          94. ArtifactAssessment.content:equity.type
          Definition

          Indicates what type of content this component represents.

          ShortWhat type of content
          Control10..1
          BindingFor example codes, see EvidenceCertaintyTypehttp://hl7.org/fhir/ValueSet/certainty-type
          (example to http://hl7.org/fhir/ValueSet/certainty-type)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Pattern Value{
            "coding" : [{
              "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
              "code" : "equity",
              "display" : "Equity"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. ArtifactAssessment.content:equity.classifier
          Definition

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

          ShortRating, classifier, or assessment
          Control10..1*
          BindingThe codes SHALL be taken from For example codes, see Rating Equityhttp://hl7.org/fhir/ValueSet/certainty-rating
          (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-equity)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          98. ArtifactAssessment.content:acceptability
          Slice Nameacceptability
          Definition

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

          ShortComment, classifier, or rating content
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          100. ArtifactAssessment.content:acceptability.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())
          102. ArtifactAssessment.content:acceptability.informationType
          Definition

          The type of information this component of the content represents.

          Shortcomment | classifier | rating | container | response | change-request
          Control10..1
          BindingThe codes SHALL be taken from ArtifactAssessmentInformationTypehttp://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0
          (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Pattern Valuerating
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          104. ArtifactAssessment.content:acceptability.type
          Definition

          Indicates what type of content this component represents.

          ShortWhat type of content
          Control10..1
          BindingFor example codes, see EvidenceCertaintyTypehttp://hl7.org/fhir/ValueSet/certainty-type
          (example to http://hl7.org/fhir/ValueSet/certainty-type)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Pattern Value{
            "coding" : [{
              "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
              "code" : "acceptability",
              "display" : "Acceptability"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          106. ArtifactAssessment.content:acceptability.classifier
          Definition

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

          ShortRating, classifier, or assessment
          Control10..1*
          BindingThe codes SHALL be taken from For example codes, see Rating Acceptabilityhttp://hl7.org/fhir/ValueSet/certainty-rating
          (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-acceptability)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          108. ArtifactAssessment.content:feasibility
          Slice Namefeasibility
          Definition

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

          ShortComment, classifier, or rating content
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          110. ArtifactAssessment.content:feasibility.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())
          112. ArtifactAssessment.content:feasibility.informationType
          Definition

          The type of information this component of the content represents.

          Shortcomment | classifier | rating | container | response | change-request
          Control10..1
          BindingThe codes SHALL be taken from ArtifactAssessmentInformationTypehttp://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0
          (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Pattern Valuerating
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          114. ArtifactAssessment.content:feasibility.type
          Definition

          Indicates what type of content this component represents.

          ShortWhat type of content
          Control10..1
          BindingFor example codes, see EvidenceCertaintyTypehttp://hl7.org/fhir/ValueSet/certainty-type
          (example to http://hl7.org/fhir/ValueSet/certainty-type)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Pattern Value{
            "coding" : [{
              "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
              "code" : "feasibility",
              "display" : "Feasibility"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          116. ArtifactAssessment.content:feasibility.classifier
          Definition

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

          ShortRating, classifier, or assessment
          Control10..1*
          BindingThe codes SHALL be taken from For example codes, see Rating Feasibilityhttp://hl7.org/fhir/ValueSet/certainty-rating
          (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-feasibility)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          118. ArtifactAssessment.content:evidenceRating
          Slice NameevidenceRating
          Definition

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

          ShortComment, classifier, or rating content
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          120. ArtifactAssessment.content:evidenceRating.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())
          122. ArtifactAssessment.content:evidenceRating.informationType
          Definition

          The type of information this component of the content represents.

          Shortcomment | classifier | rating | container | response | change-request
          Control10..1
          BindingThe codes SHALL be taken from ArtifactAssessmentInformationTypehttp://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0
          (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Pattern Valuecontainer
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          124. ArtifactAssessment.content:evidenceRating.type
          Definition

          Indicates what type of content this component represents.

          ShortWhat type of content
          Control10..1
          BindingFor example codes, see EvidenceCertaintyTypehttp://hl7.org/fhir/ValueSet/certainty-type
          (example to http://hl7.org/fhir/ValueSet/certainty-type)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Pattern Value{
            "coding" : [{
              "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
              "code" : "certainty-of-evidence-rating",
              "display" : "Certainty of evidence rating"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          126. ArtifactAssessment.content:evidenceRating.relatedArtifact
          Definition

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

          ShortAdditional information
          Control10..1*
          TypeRelatedArtifact
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          128. ArtifactAssessment.content:evidenceRating.relatedArtifact.type
          Definition

          The type of relationship to the related artifact.

          Shortdocumentation | justification | citation | 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 | documents | specification-of | created-with | cite-as
          Comments

          The presence of both sides of a relationship type (e.g. successor and predecessor) is required to support use cases where one side of a relationship is not represented in FHIR. However, this feature SHALL NOT be used to create bi-directional resource links in FHIR instances. Specifically, following the methodology of "new points to old" and "many points to one", when using related artifact elements to describe and reference FHIR resources, the type element SHALL be drawn from the fhir-related-artifact-type ValueSet.

          Control1..1
          BindingThe codes SHALL be taken from RelatedArtifactTypehttp://hl7.org/fhir/ValueSet/related-artifact-type|5.0.0
          (required to http://hl7.org/fhir/ValueSet/related-artifact-type|5.0.0)

          The type of relationship to the related artifact.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Pattern Valuejustification
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          130. ArtifactAssessment.content:evidenceRating.relatedArtifact.classifier
          Definition

          Provides additional classifiers of the related artifact.

          ShortAdditional classifiers
          Control10..1*
          BindingFor example codes, see CitationArtifactClassifierhttp://hl7.org/fhir/ValueSet/citation-artifact-classifier
          (example to http://hl7.org/fhir/ValueSet/citation-artifact-classifier)

          Additional classifiers for the related artifact.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Pattern Value{
            "coding" : [{
              "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
              "code" : "certainty-of-evidence-rating",
              "display" : "Certainty of evidence rating"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          132. ArtifactAssessment.content:evidenceRating.relatedArtifact.resourceReference
          Definition

          The related artifact, if the artifact is not a canonical resource, or a resource reference to a canonical resource.

          ShortWhat artifact, if not a conformance resource
          Comments

          If both resource and resourceReference are present, they SHOULD be consistent and reference the same resource. Although relatedArtifact is intended to support references to definitional resources, there are cases where non-definitional resources can be definitional (such as Location where the kind is mode). Related artifacts SHOULD be used to reference definitional resources, and profiles SHOULD be used to make that explicit for particular use cases.

          Control10..1
          TypeReference(Certainty of Evidence Rating, Resource)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          134. ArtifactAssessment.content:netEffect
          Slice NamenetEffect
          Definition

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

          ShortComment, classifier, or rating content
          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()))
          136. ArtifactAssessment.content:netEffect.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())
          138. ArtifactAssessment.content:netEffect.informationType
          Definition

          The type of information this component of the content represents.

          Shortcomment | classifier | rating | container | response | change-request
          Control10..1
          BindingThe codes SHALL be taken from ArtifactAssessmentInformationTypehttp://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0
          (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Pattern Valuecontainer
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          140. ArtifactAssessment.content:netEffect.type
          Definition

          Indicates what type of content this component represents.

          ShortWhat type of content
          Control10..1
          BindingFor example codes, see EvidenceCertaintyTypehttp://hl7.org/fhir/ValueSet/certainty-type
          (example to http://hl7.org/fhir/ValueSet/certainty-type)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Pattern Value{
            "coding" : [{
              "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
              "code" : "net-effect",
              "display" : "Net effect"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          142. ArtifactAssessment.content:netEffect.relatedArtifact
          Definition

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

          ShortAdditional information
          Control10..1*
          TypeRelatedArtifact
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          144. ArtifactAssessment.content:netEffect.relatedArtifact.type
          Definition

          The type of relationship to the related artifact.

          Shortdocumentation | justification | citation | 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 | documents | specification-of | created-with | cite-as
          Comments

          The presence of both sides of a relationship type (e.g. successor and predecessor) is required to support use cases where one side of a relationship is not represented in FHIR. However, this feature SHALL NOT be used to create bi-directional resource links in FHIR instances. Specifically, following the methodology of "new points to old" and "many points to one", when using related artifact elements to describe and reference FHIR resources, the type element SHALL be drawn from the fhir-related-artifact-type ValueSet.

          Control1..1
          BindingThe codes SHALL be taken from RelatedArtifactTypehttp://hl7.org/fhir/ValueSet/related-artifact-type|5.0.0
          (required to http://hl7.org/fhir/ValueSet/related-artifact-type|5.0.0)

          The type of relationship to the related artifact.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Pattern Valuesupported-with
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          146. ArtifactAssessment.content:netEffect.relatedArtifact.classifier
          Definition

          Provides additional classifiers of the related artifact.

          ShortAdditional classifiers
          Control10..1*
          BindingFor example codes, see CitationArtifactClassifierhttp://hl7.org/fhir/ValueSet/citation-artifact-classifier
          (example to http://hl7.org/fhir/ValueSet/citation-artifact-classifier)

          Additional classifiers for the related artifact.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Pattern Value{
            "coding" : [{
              "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
              "code" : "net-effect",
              "display" : "Net effect"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          148. ArtifactAssessment.content:netEffect.relatedArtifact.resourceReference
          Definition

          The related artifact, if the artifact is not a canonical resource, or a resource reference to a canonical resource.

          ShortWhat artifact, if not a conformance resource
          Comments

          If both resource and resourceReference are present, they SHOULD be consistent and reference the same resource. Although relatedArtifact is intended to support references to definitional resources, there are cases where non-definitional resources can be definitional (such as Location where the kind is mode). Related artifacts SHOULD be used to reference definitional resources, and profiles SHOULD be used to make that explicit for particular use cases.

          Control10..1
          TypeReference(Net Effect Estimate, Resource)
          Is Modifierfalse
          Must Supporttrue
          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. ArtifactAssessment
          Definition

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

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

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

          ShortLogical id of this artifact
          Comments

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

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

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

          ShortMetadata about the resource
          Control1..1
          TypeMeta
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. ArtifactAssessment.meta.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
          8. ArtifactAssessment.meta.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 ArtifactAssessment.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 10. ArtifactAssessment.meta.versionId
            Definition

            The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

            ShortVersion specific identifier
            Comments

            The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

            Control0..1
            Typeid
            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()))
            12. ArtifactAssessment.meta.lastUpdated
            Definition

            When the resource last changed - e.g. when the version changed.

            ShortWhen the resource version last changed
            Comments

            This element is generally omitted in instances submitted in a PUT or POST. Instead, it is populated in the response instance and when retrieving information using a GET. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

            Control0..1
            Typeinstant
            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()))
            14. ArtifactAssessment.meta.source
            Definition

            A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

            ShortIdentifies where the resource comes from
            Comments

            The exact use of the source (and the possible implied Provenance.entity.role and agent.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. The source may correspond to Provenance.entity.what[x] or Provenance.agent.who[x], though it may be a more general or abstract reference.

            This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

            Control0..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            16. ArtifactAssessment.meta.profile
            Definition

            A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

            ShortProfiles this resource claims to conform to
            Comments

            It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

            Control1..*
            Typecanonical(StructureDefinition)
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            18. ArtifactAssessment.meta.security
            Definition

            Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

            ShortSecurity Labels applied to this resource
            Comments

            The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

            Control0..*
            BindingUnless not suitable, these codes SHALL be taken from AllSecurityLabels
            (extensible to http://hl7.org/fhir/ValueSet/security-labels)

            Security Labels from the Healthcare Privacy and Security Classification System.

            TypeCoding
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            20. ArtifactAssessment.meta.tag
            Definition

            Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

            ShortTags applied to this resource
            Comments

            The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

            Control0..*
            BindingFor example codes, see CommonTags
            (example to http://hl7.org/fhir/ValueSet/common-tags)

            Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

            TypeCoding
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            22. 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()))
            24. ArtifactAssessment.language
            Definition

            The base language in which the resource is written.

            ShortLanguage of the resource content
            Comments

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

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

            IETF language tag for a human language

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

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

            ShortText summary of the resource, for human interpretation
            Comments

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

            Control0..1
            This element is affected by the following invariants: dom-6
            TypeNarrative
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Alternate Namesnarrative, html, xhtml, display
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. 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
            30. ArtifactAssessment.extension
            Definition

            An Extension

            ShortExtension
            Control2..*
            TypeExtension
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on ArtifactAssessment.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 32. ArtifactAssessment.extension:version
              Slice Nameversion
              Definition

              Extension used on Artifact Assessment resources to describe the guideline recommendation version.

              ShortVersion
              Control1..1
              TypeExtension(ArtifactAssessment Version) (Extension Type: string)
              Is Modifierfalse
              Must Supporttrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              34. ArtifactAssessment.extension:publicationStatus
              Slice NamepublicationStatus
              Definition

              Extension used on ArtifactAssessment resources to describe the guideline recommendation publication status.

              ShortPublication status
              Control1..1
              TypeExtension(ArtifactAssessment Publication Status) (Extension Type: code)
              Is Modifierfalse
              Must Supporttrue
              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. ArtifactAssessment.modifierExtension
              Definition

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

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

              ShortExtensions that cannot be ignored
              Comments

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

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

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

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

              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 artifact assessment
              Comments

              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 artifact assessment.

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

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

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

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

              ShortHow 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()))
              44. ArtifactAssessment.date
              Definition

              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.

              Control1..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()))
              46. ArtifactAssessment.copyright
              Definition

              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 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()))
              48. 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 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()))
              50. 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 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()))
              52. ArtifactAssessment.artifact[x]
              Definition

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

              ShortThe artifact assessed, commented upon or rated
              Control1..1
              TypeReference(Recommendation Plan)
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              54. ArtifactAssessment.content
              Definition

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

              ShortComment, classifier, or rating content
              Control2..*
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              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 ArtifactAssessment.content. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
              • value @ type
              • 56. ArtifactAssessment.content.id
                Definition

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

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

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

                ShortAdditional content defined by implementations
                Comments

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

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

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

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

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

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

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

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

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

                The type of information this component of the content represents.

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

                A brief summary of the content of this component.

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

                Indicates what type of content this component represents.

                ShortWhat type of content
                Control0..1
                BindingFor example codes, see EvidenceCertaintyType
                (example to http://hl7.org/fhir/ValueSet/certainty-type)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                68. ArtifactAssessment.content.classifier
                Definition

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

                ShortRating, classifier, or assessment
                Control0..*
                BindingFor example codes, see EvidenceCertaintyRating
                (example to http://hl7.org/fhir/ValueSet/certainty-rating)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                70. ArtifactAssessment.content.quantity
                Definition

                A quantitative rating of the artifact.

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

                Indicates who or what authored the content.

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

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

                ShortWhat the comment is directed to
                Comments

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

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

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

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

                Acceptable to publicly share the comment, classifier or rating.

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

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

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

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

                ShortComment, classifier, or rating content
                Control1..1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                84. ArtifactAssessment.content:strength.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
                86. ArtifactAssessment.content:strength.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())
                88. ArtifactAssessment.content:strength.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())
                90. ArtifactAssessment.content:strength.informationType
                Definition

                The type of information this component of the content represents.

                Shortcomment | classifier | rating | container | response | change-request
                Control1..1
                BindingThe codes SHALL be taken from ArtifactAssessmentInformationType
                (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Pattern Valuerating
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                92. ArtifactAssessment.content:strength.summary
                Definition

                A brief summary of the content of this component.

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

                Indicates what type of content this component represents.

                ShortWhat type of content
                Control1..1
                BindingFor example codes, see EvidenceCertaintyType
                (example to http://hl7.org/fhir/ValueSet/certainty-type)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Pattern Value{
                  "coding" : [{
                    "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
                    "code" : "strength",
                    "display" : "Strength of recommendation"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                96. ArtifactAssessment.content:strength.classifier
                Definition

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

                ShortRating, classifier, or assessment
                Control1..1
                BindingThe codes SHALL be taken from Recommendation Strength
                (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/ceosys-vs-recommendation-strength)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                98. ArtifactAssessment.content:strength.quantity
                Definition

                A quantitative rating of the artifact.

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

                Indicates who or what authored the content.

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

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

                ShortWhat the comment is directed to
                Comments

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

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

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

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

                Acceptable to publicly share the comment, classifier or rating.

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

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

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

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

                ShortComment, classifier, or rating content
                Control0..1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                112. ArtifactAssessment.content:consensus.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
                114. ArtifactAssessment.content:consensus.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())
                116. ArtifactAssessment.content:consensus.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())
                118. ArtifactAssessment.content:consensus.informationType
                Definition

                The type of information this component of the content represents.

                Shortcomment | classifier | rating | container | response | change-request
                Control1..1
                BindingThe codes SHALL be taken from ArtifactAssessmentInformationType
                (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Pattern Valuerating
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                120. ArtifactAssessment.content:consensus.summary
                Definition

                A brief summary of the content of this component.

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

                Indicates what type of content this component represents.

                ShortWhat type of content
                Control1..1
                BindingFor example codes, see EvidenceCertaintyType
                (example to http://hl7.org/fhir/ValueSet/certainty-type)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Pattern Value{
                  "coding" : [{
                    "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
                    "code" : "consensus",
                    "display" : "Consensus"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                124. ArtifactAssessment.content:consensus.classifier
                Definition

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

                ShortRating, classifier, or assessment
                Control1..1
                BindingThe codes SHALL be taken from Rating Consensus
                (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-consensus)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                126. ArtifactAssessment.content:consensus.quantity
                Definition

                A quantitative rating of the artifact.

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

                Indicates who or what authored the content.

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

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

                ShortWhat the comment is directed to
                Comments

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

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

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

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

                Acceptable to publicly share the comment, classifier or rating.

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

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

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

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

                ShortComment, classifier, or rating content
                Control0..1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                140. ArtifactAssessment.content:benefitAndHarms.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
                142. ArtifactAssessment.content:benefitAndHarms.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())
                144. ArtifactAssessment.content:benefitAndHarms.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())
                146. ArtifactAssessment.content:benefitAndHarms.informationType
                Definition

                The type of information this component of the content represents.

                Shortcomment | classifier | rating | container | response | change-request
                Control1..1
                BindingThe codes SHALL be taken from ArtifactAssessmentInformationType
                (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Pattern Valuerating
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                148. ArtifactAssessment.content:benefitAndHarms.summary
                Definition

                A brief summary of the content of this component.

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

                Indicates what type of content this component represents.

                ShortWhat type of content
                Control1..1
                BindingFor example codes, see EvidenceCertaintyType
                (example to http://hl7.org/fhir/ValueSet/certainty-type)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Pattern Value{
                  "coding" : [{
                    "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
                    "code" : "benefit-and-harms",
                    "display" : "Benefit and harms"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                152. ArtifactAssessment.content:benefitAndHarms.classifier
                Definition

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

                ShortRating, classifier, or assessment
                Control1..1
                BindingThe codes SHALL be taken from Rating Benefit And Harms
                (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-benefit-and-harms)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                154. ArtifactAssessment.content:benefitAndHarms.quantity
                Definition

                A quantitative rating of the artifact.

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

                Indicates who or what authored the content.

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

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

                ShortWhat the comment is directed to
                Comments

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

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

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

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

                Acceptable to publicly share the comment, classifier or rating.

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

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

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

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

                ShortComment, classifier, or rating content
                Control0..1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                168. ArtifactAssessment.content:certaintyOfEvidence.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
                170. ArtifactAssessment.content:certaintyOfEvidence.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())
                172. ArtifactAssessment.content:certaintyOfEvidence.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())
                174. ArtifactAssessment.content:certaintyOfEvidence.informationType
                Definition

                The type of information this component of the content represents.

                Shortcomment | classifier | rating | container | response | change-request
                Control1..1
                BindingThe codes SHALL be taken from ArtifactAssessmentInformationType
                (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Pattern Valuerating
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                176. ArtifactAssessment.content:certaintyOfEvidence.summary
                Definition

                A brief summary of the content of this component.

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

                Indicates what type of content this component represents.

                ShortWhat type of content
                Control1..1
                BindingFor example codes, see EvidenceCertaintyType
                (example to http://hl7.org/fhir/ValueSet/certainty-type)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Pattern Value{
                  "coding" : [{
                    "system" : "http://hl7.org/fhir/certainty-type",
                    "code" : "Overall",
                    "display" : "Overall certainty"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                180. ArtifactAssessment.content:certaintyOfEvidence.classifier
                Definition

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

                ShortRating, classifier, or assessment
                Control1..1
                BindingThe codes SHALL be taken from Rating Certainty Of Evidence
                (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-certainty-of-evidence)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                182. ArtifactAssessment.content:certaintyOfEvidence.quantity
                Definition

                A quantitative rating of the artifact.

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

                Indicates who or what authored the content.

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

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

                ShortWhat the comment is directed to
                Comments

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

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

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

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

                Acceptable to publicly share the comment, classifier or rating.

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

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

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

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

                ShortComment, classifier, or rating content
                Control0..1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                196. ArtifactAssessment.content:preferenceAndValues.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
                198. ArtifactAssessment.content:preferenceAndValues.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())
                200. ArtifactAssessment.content:preferenceAndValues.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())
                202. ArtifactAssessment.content:preferenceAndValues.informationType
                Definition

                The type of information this component of the content represents.

                Shortcomment | classifier | rating | container | response | change-request
                Control1..1
                BindingThe codes SHALL be taken from ArtifactAssessmentInformationType
                (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Pattern Valuerating
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                204. ArtifactAssessment.content:preferenceAndValues.summary
                Definition

                A brief summary of the content of this component.

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

                Indicates what type of content this component represents.

                ShortWhat type of content
                Control1..1
                BindingFor example codes, see EvidenceCertaintyType
                (example to http://hl7.org/fhir/ValueSet/certainty-type)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Pattern Value{
                  "coding" : [{
                    "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
                    "code" : "preference-and-values",
                    "display" : "Preference and values"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                208. ArtifactAssessment.content:preferenceAndValues.classifier
                Definition

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

                ShortRating, classifier, or assessment
                Control1..1
                BindingThe codes SHALL be taken from Rating Preference And Values
                (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-preference-and-values)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                210. ArtifactAssessment.content:preferenceAndValues.quantity
                Definition

                A quantitative rating of the artifact.

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

                Indicates who or what authored the content.

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

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

                ShortWhat the comment is directed to
                Comments

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

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

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

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

                Acceptable to publicly share the comment, classifier or rating.

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

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

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

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

                ShortComment, classifier, or rating content
                Control0..1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                224. ArtifactAssessment.content:resources.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
                226. ArtifactAssessment.content:resources.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())
                228. ArtifactAssessment.content:resources.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. ArtifactAssessment.content:resources.informationType
                Definition

                The type of information this component of the content represents.

                Shortcomment | classifier | rating | container | response | change-request
                Control1..1
                BindingThe codes SHALL be taken from ArtifactAssessmentInformationType
                (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Pattern Valuerating
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                232. ArtifactAssessment.content:resources.summary
                Definition

                A brief summary of the content of this component.

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

                Indicates what type of content this component represents.

                ShortWhat type of content
                Control1..1
                BindingFor example codes, see EvidenceCertaintyType
                (example to http://hl7.org/fhir/ValueSet/certainty-type)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Pattern Value{
                  "coding" : [{
                    "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
                    "code" : "resources",
                    "display" : "Resources"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                236. ArtifactAssessment.content:resources.classifier
                Definition

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

                ShortRating, classifier, or assessment
                Control1..1
                BindingThe codes SHALL be taken from Rating Resources
                (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-resources)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                238. ArtifactAssessment.content:resources.quantity
                Definition

                A quantitative rating of the artifact.

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

                Indicates who or what authored the content.

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

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

                ShortWhat the comment is directed to
                Comments

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

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

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

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

                Acceptable to publicly share the comment, classifier or rating.

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

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

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

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

                ShortComment, classifier, or rating content
                Control0..1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                252. ArtifactAssessment.content:equity.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
                254. ArtifactAssessment.content:equity.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())
                256. ArtifactAssessment.content:equity.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())
                258. ArtifactAssessment.content:equity.informationType
                Definition

                The type of information this component of the content represents.

                Shortcomment | classifier | rating | container | response | change-request
                Control1..1
                BindingThe codes SHALL be taken from ArtifactAssessmentInformationType
                (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Pattern Valuerating
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                260. ArtifactAssessment.content:equity.summary
                Definition

                A brief summary of the content of this component.

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

                Indicates what type of content this component represents.

                ShortWhat type of content
                Control1..1
                BindingFor example codes, see EvidenceCertaintyType
                (example to http://hl7.org/fhir/ValueSet/certainty-type)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Pattern Value{
                  "coding" : [{
                    "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
                    "code" : "equity",
                    "display" : "Equity"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                264. ArtifactAssessment.content:equity.classifier
                Definition

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

                ShortRating, classifier, or assessment
                Control1..1
                BindingThe codes SHALL be taken from Rating Equity
                (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-equity)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                266. ArtifactAssessment.content:equity.quantity
                Definition

                A quantitative rating of the artifact.

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

                Indicates who or what authored the content.

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

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

                ShortWhat the comment is directed to
                Comments

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

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

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

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

                Acceptable to publicly share the comment, classifier or rating.

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

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

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

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

                ShortComment, classifier, or rating content
                Control0..1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                280. ArtifactAssessment.content:acceptability.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
                282. ArtifactAssessment.content:acceptability.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())
                284. ArtifactAssessment.content:acceptability.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())
                286. ArtifactAssessment.content:acceptability.informationType
                Definition

                The type of information this component of the content represents.

                Shortcomment | classifier | rating | container | response | change-request
                Control1..1
                BindingThe codes SHALL be taken from ArtifactAssessmentInformationType
                (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Pattern Valuerating
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                288. ArtifactAssessment.content:acceptability.summary
                Definition

                A brief summary of the content of this component.

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

                Indicates what type of content this component represents.

                ShortWhat type of content
                Control1..1
                BindingFor example codes, see EvidenceCertaintyType
                (example to http://hl7.org/fhir/ValueSet/certainty-type)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Pattern Value{
                  "coding" : [{
                    "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
                    "code" : "acceptability",
                    "display" : "Acceptability"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                292. ArtifactAssessment.content:acceptability.classifier
                Definition

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

                ShortRating, classifier, or assessment
                Control1..1
                BindingThe codes SHALL be taken from Rating Acceptability
                (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-acceptability)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                294. ArtifactAssessment.content:acceptability.quantity
                Definition

                A quantitative rating of the artifact.

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

                Indicates who or what authored the content.

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

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

                ShortWhat the comment is directed to
                Comments

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

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

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

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

                Acceptable to publicly share the comment, classifier or rating.

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

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

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

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

                ShortComment, classifier, or rating content
                Control0..1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                308. ArtifactAssessment.content:feasibility.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. ArtifactAssessment.content:feasibility.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. ArtifactAssessment.content:feasibility.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. ArtifactAssessment.content:feasibility.informationType
                Definition

                The type of information this component of the content represents.

                Shortcomment | classifier | rating | container | response | change-request
                Control1..1
                BindingThe codes SHALL be taken from ArtifactAssessmentInformationType
                (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Pattern Valuerating
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                316. ArtifactAssessment.content:feasibility.summary
                Definition

                A brief summary of the content of this component.

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

                Indicates what type of content this component represents.

                ShortWhat type of content
                Control1..1
                BindingFor example codes, see EvidenceCertaintyType
                (example to http://hl7.org/fhir/ValueSet/certainty-type)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Pattern Value{
                  "coding" : [{
                    "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/cs-evidence-to-decision-certainty-type",
                    "code" : "feasibility",
                    "display" : "Feasibility"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                320. ArtifactAssessment.content:feasibility.classifier
                Definition

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

                ShortRating, classifier, or assessment
                Control1..1
                BindingThe codes SHALL be taken from Rating Feasibility
                (required to https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-rating-feasibility)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                322. ArtifactAssessment.content:feasibility.quantity
                Definition

                A quantitative rating of the artifact.

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

                Indicates who or what authored the content.

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

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

                ShortWhat the comment is directed to
                Comments

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

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

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

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

                Acceptable to publicly share the comment, classifier or rating.

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

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

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

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

                ShortComment, classifier, or rating content
                Control0..*
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                336. ArtifactAssessment.content:evidenceRating.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
                338. ArtifactAssessment.content:evidenceRating.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())
                340. ArtifactAssessment.content:evidenceRating.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())
                342. ArtifactAssessment.content:evidenceRating.informationType
                Definition

                The type of information this component of the content represents.

                Shortcomment | classifier | rating | container | response | change-request
                Control1..1
                BindingThe codes SHALL be taken from ArtifactAssessmentInformationType
                (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Pattern Valuecontainer
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                344. ArtifactAssessment.content:evidenceRating.summary
                Definition

                A brief summary of the content of this component.

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

                Indicates what type of content this component represents.

                ShortWhat type of content
                Control1..1
                BindingFor example codes, see EvidenceCertaintyType
                (example to http://hl7.org/fhir/ValueSet/certainty-type)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Pattern Value{
                  "coding" : [{
                    "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
                    "code" : "certainty-of-evidence-rating",
                    "display" : "Certainty of evidence rating"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                348. ArtifactAssessment.content:evidenceRating.classifier
                Definition

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

                ShortRating, classifier, or assessment
                Control0..*
                BindingFor example codes, see EvidenceCertaintyRating
                (example to http://hl7.org/fhir/ValueSet/certainty-rating)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                350. ArtifactAssessment.content:evidenceRating.quantity
                Definition

                A quantitative rating of the artifact.

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

                Indicates who or what authored the content.

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

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

                ShortWhat the comment is directed to
                Comments

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

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

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

                ShortAdditional information
                Control1..1
                TypeRelatedArtifact
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                358. ArtifactAssessment.content:evidenceRating.relatedArtifact.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
                360. ArtifactAssessment.content:evidenceRating.relatedArtifact.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 ArtifactAssessment.content.relatedArtifact.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 362. ArtifactAssessment.content:evidenceRating.relatedArtifact.type
                  Definition

                  The type of relationship to the related artifact.

                  Shortdocumentation | justification | citation | 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 | documents | specification-of | created-with | cite-as
                  Comments

                  The presence of both sides of a relationship type (e.g. successor and predecessor) is required to support use cases where one side of a relationship is not represented in FHIR. However, this feature SHALL NOT be used to create bi-directional resource links in FHIR instances. Specifically, following the methodology of "new points to old" and "many points to one", when using related artifact elements to describe and reference FHIR resources, the type element SHALL be drawn from the fhir-related-artifact-type ValueSet.

                  Control1..1
                  BindingThe codes SHALL be taken from RelatedArtifactType
                  (required to http://hl7.org/fhir/ValueSet/related-artifact-type|5.0.0)

                  The type of relationship to the related artifact.

                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Pattern Valuejustification
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  364. ArtifactAssessment.content:evidenceRating.relatedArtifact.classifier
                  Definition

                  Provides additional classifiers of the related artifact.

                  ShortAdditional classifiers
                  Control1..1
                  BindingFor example codes, see CitationArtifactClassifier
                  (example to http://hl7.org/fhir/ValueSet/citation-artifact-classifier)

                  Additional classifiers for the related artifact.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Pattern Value{
                    "coding" : [{
                      "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
                      "code" : "certainty-of-evidence-rating",
                      "display" : "Certainty of evidence rating"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  366. ArtifactAssessment.content:evidenceRating.relatedArtifact.label
                  Definition

                  A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

                  ShortShort label
                  Control0..1
                  Typestring
                  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()))
                  368. ArtifactAssessment.content:evidenceRating.relatedArtifact.display
                  Definition

                  A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

                  ShortBrief description of the related artifact
                  Control0..1
                  Typestring
                  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()))
                  370. ArtifactAssessment.content:evidenceRating.relatedArtifact.citation
                  Definition

                  A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.

                  ShortBibliographic citation for the artifact
                  Comments

                  Additional structured information about citations should be captured as extensions.

                  Control0..1
                  Typemarkdown
                  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()))
                  372. ArtifactAssessment.content:evidenceRating.relatedArtifact.document
                  Definition

                  The document being referenced, represented as an attachment. This is exclusive with the resource element.

                  ShortWhat document is being referenced
                  Control0..1
                  TypeAttachment
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  374. ArtifactAssessment.content:evidenceRating.relatedArtifact.resource
                  Definition

                  The related artifact, such as a library, value set, profile, or other knowledge resource.

                  ShortWhat artifact is being referenced
                  Comments

                  If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

                  Control0..1
                  Typecanonical(Resource)
                  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()))
                  376. ArtifactAssessment.content:evidenceRating.relatedArtifact.resourceReference
                  Definition

                  The related artifact, if the artifact is not a canonical resource, or a resource reference to a canonical resource.

                  ShortWhat artifact, if not a conformance resource
                  Comments

                  If both resource and resourceReference are present, they SHOULD be consistent and reference the same resource. Although relatedArtifact is intended to support references to definitional resources, there are cases where non-definitional resources can be definitional (such as Location where the kind is mode). Related artifacts SHOULD be used to reference definitional resources, and profiles SHOULD be used to make that explicit for particular use cases.

                  Control1..1
                  TypeReference(Certainty of Evidence Rating)
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  378. ArtifactAssessment.content:evidenceRating.relatedArtifact.publicationStatus
                  Definition

                  The publication status of the artifact being referred to.

                  Shortdraft | active | retired | unknown
                  Control0..1
                  BindingThe codes SHALL be taken from PublicationStatus
                  (required to http://hl7.org/fhir/ValueSet/publication-status|5.0.0)

                  Publication status of an artifact being referred to.

                  Typecode
                  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()))
                  380. ArtifactAssessment.content:evidenceRating.relatedArtifact.publicationDate
                  Definition

                  The date of publication of the artifact being referred to.

                  ShortDate of publication of the artifact being referred to
                  Control0..1
                  Typedate
                  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()))
                  382. ArtifactAssessment.content:evidenceRating.freeToShare
                  Definition

                  Acceptable to publicly share the comment, classifier or rating.

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

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

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

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

                  ShortComment, classifier, or rating content
                  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()))
                  388. ArtifactAssessment.content:netEffect.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
                  390. ArtifactAssessment.content:netEffect.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())
                  392. ArtifactAssessment.content:netEffect.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())
                  394. ArtifactAssessment.content:netEffect.informationType
                  Definition

                  The type of information this component of the content represents.

                  Shortcomment | classifier | rating | container | response | change-request
                  Control1..1
                  BindingThe codes SHALL be taken from ArtifactAssessmentInformationType
                  (required to http://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0)
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summaryfalse
                  Pattern Valuecontainer
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  396. ArtifactAssessment.content:netEffect.summary
                  Definition

                  A brief summary of the content of this component.

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

                  Indicates what type of content this component represents.

                  ShortWhat type of content
                  Control1..1
                  BindingFor example codes, see EvidenceCertaintyType
                  (example to http://hl7.org/fhir/ValueSet/certainty-type)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Pattern Value{
                    "coding" : [{
                      "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
                      "code" : "net-effect",
                      "display" : "Net effect"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  400. ArtifactAssessment.content:netEffect.classifier
                  Definition

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

                  ShortRating, classifier, or assessment
                  Control0..*
                  BindingFor example codes, see EvidenceCertaintyRating
                  (example to http://hl7.org/fhir/ValueSet/certainty-rating)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  402. ArtifactAssessment.content:netEffect.quantity
                  Definition

                  A quantitative rating of the artifact.

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

                  Indicates who or what authored the content.

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

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

                  ShortWhat the comment is directed to
                  Comments

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

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

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

                  ShortAdditional information
                  Control1..1
                  TypeRelatedArtifact
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  410. ArtifactAssessment.content:netEffect.relatedArtifact.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
                  412. ArtifactAssessment.content:netEffect.relatedArtifact.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 ArtifactAssessment.content.relatedArtifact.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 414. ArtifactAssessment.content:netEffect.relatedArtifact.type
                    Definition

                    The type of relationship to the related artifact.

                    Shortdocumentation | justification | citation | 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 | documents | specification-of | created-with | cite-as
                    Comments

                    The presence of both sides of a relationship type (e.g. successor and predecessor) is required to support use cases where one side of a relationship is not represented in FHIR. However, this feature SHALL NOT be used to create bi-directional resource links in FHIR instances. Specifically, following the methodology of "new points to old" and "many points to one", when using related artifact elements to describe and reference FHIR resources, the type element SHALL be drawn from the fhir-related-artifact-type ValueSet.

                    Control1..1
                    BindingThe codes SHALL be taken from RelatedArtifactType
                    (required to http://hl7.org/fhir/ValueSet/related-artifact-type|5.0.0)

                    The type of relationship to the related artifact.

                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Pattern Valuesupported-with
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    416. ArtifactAssessment.content:netEffect.relatedArtifact.classifier
                    Definition

                    Provides additional classifiers of the related artifact.

                    ShortAdditional classifiers
                    Control1..1
                    BindingFor example codes, see CitationArtifactClassifier
                    (example to http://hl7.org/fhir/ValueSet/citation-artifact-classifier)

                    Additional classifiers for the related artifact.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Pattern Value{
                      "coding" : [{
                        "system" : "https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system",
                        "code" : "net-effect",
                        "display" : "Net effect"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    418. ArtifactAssessment.content:netEffect.relatedArtifact.label
                    Definition

                    A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.

                    ShortShort label
                    Control0..1
                    Typestring
                    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()))
                    420. ArtifactAssessment.content:netEffect.relatedArtifact.display
                    Definition

                    A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.

                    ShortBrief description of the related artifact
                    Control0..1
                    Typestring
                    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()))
                    422. ArtifactAssessment.content:netEffect.relatedArtifact.citation
                    Definition

                    A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.

                    ShortBibliographic citation for the artifact
                    Comments

                    Additional structured information about citations should be captured as extensions.

                    Control0..1
                    Typemarkdown
                    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()))
                    424. ArtifactAssessment.content:netEffect.relatedArtifact.document
                    Definition

                    The document being referenced, represented as an attachment. This is exclusive with the resource element.

                    ShortWhat document is being referenced
                    Control0..1
                    TypeAttachment
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    426. ArtifactAssessment.content:netEffect.relatedArtifact.resource
                    Definition

                    The related artifact, such as a library, value set, profile, or other knowledge resource.

                    ShortWhat artifact is being referenced
                    Comments

                    If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.

                    Control0..1
                    Typecanonical(Resource)
                    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()))
                    428. ArtifactAssessment.content:netEffect.relatedArtifact.resourceReference
                    Definition

                    The related artifact, if the artifact is not a canonical resource, or a resource reference to a canonical resource.

                    ShortWhat artifact, if not a conformance resource
                    Comments

                    If both resource and resourceReference are present, they SHOULD be consistent and reference the same resource. Although relatedArtifact is intended to support references to definitional resources, there are cases where non-definitional resources can be definitional (such as Location where the kind is mode). Related artifacts SHOULD be used to reference definitional resources, and profiles SHOULD be used to make that explicit for particular use cases.

                    Control1..1
                    TypeReference(Net Effect Estimate)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    430. ArtifactAssessment.content:netEffect.relatedArtifact.publicationStatus
                    Definition

                    The publication status of the artifact being referred to.

                    Shortdraft | active | retired | unknown
                    Control0..1
                    BindingThe codes SHALL be taken from PublicationStatus
                    (required to http://hl7.org/fhir/ValueSet/publication-status|5.0.0)

                    Publication status of an artifact being referred to.

                    Typecode
                    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()))
                    432. ArtifactAssessment.content:netEffect.relatedArtifact.publicationDate
                    Definition

                    The date of publication of the artifact being referred to.

                    ShortDate of publication of the artifact being referred to
                    Control0..1
                    Typedate
                    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()))
                    434. ArtifactAssessment.content:netEffect.freeToShare
                    Definition

                    Acceptable to publicly share the comment, classifier or rating.

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

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

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

                    Indicates the workflow status of the comment or change request.

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

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

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