Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot3 - STU 1 Ballot 3 World

Evidence Based Medicine on FHIR Implementation Guide, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot3 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/ebm/ and changes regularly. See the Directory of published versions

Resource Profile: M11ReportSection06 - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 1

Definitions for the m11-report-section-06 resource profile

See the documentation on how to interpret the contents of this table

0. Composition
Definition

Composition provides the structural backbone for assembling a set of healthcare-related information into a single logical package that provides a single coherent statement of meaning, establishes its own context and has traceability to the author who is making the statement.

ShortA set of resources composed into a single coherent clinical statement with clinical attestation
Comments

While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

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.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').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. Composition.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. For DomainResources, if more than one implicitRules policy applies, additional policies may be conveyed using the additionalImplicitRules extension.

ShortA set of rules under which this content was created
Comments

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

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

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

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

ShortHow to compare versions
Comments

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

Control0..1
TypeExtension(Artifact Version Algorithm) (Extension Type: Choice of: string, Coding)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Composition.extension:experimental
Slice Nameexperimental
Definition

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

ShortFor testing purposes, not real usage
Control0..1
TypeExtension(Artifact Experimental) (Extension Type: boolean)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Composition.extension:description
Slice Namedescription
Definition

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

ShortNatural language description of the artifact
Comments

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

Control0..1
TypeExtension(Artifact Description) (Extension Type: markdown)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Composition.extension:purpose
Slice Namepurpose
Definition

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

ShortWhy this artifact is defined
Comments

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

Control0..1
TypeExtension(Artifact Purpose) (Extension Type: markdown)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Composition.extension:copyright
Slice Namecopyright
Definition

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

ShortUse and/or publishing restrictions
Comments

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

Control0..1
TypeExtension(Artifact Copyright) (Extension Type: markdown)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Composition.extension:copyrightLabel
Slice NamecopyrightLabel
Definition

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

ShortCopyright holder and year(s)
Comments

Defines the content expected to be rendered in all representations of the artifact. The (c) symbol should NOT be included in this string. It is expected to be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

Control0..1
TypeExtension(Artifact Copyright Label) (Extension Type: string)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Composition.extension:approvalDate
Slice NameapprovalDate
Definition

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

ShortWhen the artifact 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
TypeExtension(Artifact Approval Date) (Extension Type: date)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Composition.extension:lastReviewDate
Slice NamelastReviewDate
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 was approved by publisher
Comments

If specified, this date follows the original approval date.

Control0..1
TypeExtension(Artifact Last Review Date) (Extension Type: date)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Composition.extension:effectivePeriod
Slice NameeffectivePeriod
Definition

The period during which the artifact content was or is planned to be in active use.

ShortWhen the artifact is expected to be used
Comments

The effective period for an artifact determines when the content is applicable for usage and is independent of publication and review dates. For example, an artifact intended to be used for the year 2016 might be published in 2015.

Control0..1
TypeExtension(Artifact Effective Period) (Extension Type: Period)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Composition.extension:additionalLanguage
Slice NameadditionalLanguage
Definition

The Resource contains content in a language additional to the one in the language element.

ShortThe additional language
Control0..*
TypeExtension(Additional Language) (Extension Type: code)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Composition.extension:extendedContactDetail
Slice NameextendedContactDetail
Definition

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

ShortContact details for the publisher
Comments

May be a web site, an email address, a physical address, a telephone number, etc.

Control0..*
TypeExtension(Artifact Extended Contact Detail) (Extension Type: ExtendedContactDetail)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Composition.extension:publicationDate
Slice NamepublicationDate
Definition

Specifies the publication date of the Resource.

ShortPublication date of Resource
Control0..1
TypeExtension(Publication Date) (Extension Type: date)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Composition.extension:publicationStatus
Slice NamepublicationStatus
Definition

The status of the processing for making the artifact publicly available, not necessarily the same as artifact status (Resource.status).

ShortPublication status
Control0..1
TypeExtension(ArtifactPublicationStatus) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Composition.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()))
SlicingThis element introduces a set of slices on Composition.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
34. Composition.status
Definition

The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

Shortregistered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown
Comments

See section 2.8.3.2, The workflow/clinical status of the composition, for guidance. Because the entered-in-error flag changes how this resource and its related elements must be interpreted, status is labeled as a modifier element. Some reporting workflows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The Composition resource has no explicit status for noting whether this business rule is in effect; this would be handled by an extension if required.

Control1..1
BindingThe codes SHALL be taken from CompositionStatushttp://hl7.org/fhir/ValueSet/composition-status|6.0.0-snapshot1
(required to http://hl7.org/fhir/ValueSet/composition-status|6.0.0-snapshot1)

The workflow status of the composition.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Requirements

Need to be able to mark interim, amended, or withdrawn compositions or documents.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Composition.type
Definition

Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

ShortKind of composition (LOINC if possible)
Comments

For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

Control1..1
BindingThe codes SHOULD be taken from FHIRDocumentTypeCodeshttp://hl7.org/fhir/ValueSet/doc-typecodes|6.0.0-snapshot1
(preferred to http://hl7.org/fhir/ValueSet/doc-typecodes|6.0.0-snapshot1)

Type of a composition.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Key metadata element describing the composition, used in searching/filtering.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Composition.type.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control10..1*
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://loinc.org",
  "code" : "35528-9",
  "display" : "Clinical trial protocol Clinical trial protocol"
}
<coding>
  <system value="http://loinc.org"/>
  <code value="35528-9"/>
  <display value="Clinical trial protocol Clinical trial protocol"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Composition.type.text
Definition

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

ShortPlain text representation of the concept
Comments

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

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

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

Pattern Value
{
  "text" : "CeSHarP Report"
}
<text value="CeSHarP Report"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. Composition.category
Definition

A categorization for the type of the composition - helps with indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

ShortCategorization of Composition
Control0..*
BindingFor example codes, see ReferencedItemCategoryValueSethttp://hl7.org/fhir/ValueSet/referenced-item-category|6.0.0-snapshot1
(example to http://hl7.org/fhir/ValueSet/referenced-item-category|6.0.0-snapshot1)

High-level kind of a clinical document at a macro level.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

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 Composition.category. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ text
44. Composition.category:intervention
Slice Nameintervention
Definition

A categorization for the type of the composition - helps with indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

ShortCategorization of Composition
Control0..1*
BindingFor example codes, see ReferencedItemCategoryValueSethttp://hl7.org/fhir/ValueSet/referenced-item-category|6.0.0-snapshot1
(example to http://hl7.org/fhir/ValueSet/referenced-item-category|6.0.0-snapshot1)

High-level kind of a clinical document at a macro level.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Composition.category:intervention.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control10..1*
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218560",
  "display" : "ICH M11 Protocol Section 6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218560"/>
  <display value="ICH M11 Protocol Section 6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Composition.category:intervention.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6-trial-intervention"
}
<text value="section6-trial-intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Composition.date
Definition

The composition editing time, when the composition was last logically changed by the author.

ShortComposition editing time
Comments

The Last Modified Date on the composition may be after the date the document was attested without being changed. This means that the date on an amended document is the date of the amendment, not the date of original authorship.

Control1..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Requirements

dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring this version of the Composition. When packaged in a document, Bundle.timestamp is the date of packaging.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. Composition.relatesTo
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.relatesTo. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ type

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

54. Composition.relatesTo.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. Composition.relatesTo.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
58. Composition.relatesTo.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Typehttp://terminology.hl7.org/ValueSet/artifact-relationship-type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. Composition.relatesTo.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
62. Composition.relatesTo:citeAs
Slice NameciteAs
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..1*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
64. Composition.relatesTo:citeAs.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. Composition.relatesTo:citeAs.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
68. Composition.relatesTo:citeAs.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Typehttp://terminology.hl7.org/ValueSet/artifact-relationship-type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "cite-as"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="cite-as"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. Composition.relatesTo:citeAs.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
72. Composition.relatesTo:partOf
Slice NamepartOf
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
74. Composition.relatesTo:partOf.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. Composition.relatesTo:partOf.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
78. Composition.relatesTo:partOf.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Typehttp://terminology.hl7.org/ValueSet/artifact-relationship-type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "part-of"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="part-of"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. Composition.relatesTo:partOf.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
82. Composition.relatesTo:derivedFrom
Slice NamederivedFrom
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
84. Composition.relatesTo:derivedFrom.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. Composition.relatesTo:derivedFrom.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
88. Composition.relatesTo:derivedFrom.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Typehttp://terminology.hl7.org/ValueSet/artifact-relationship-type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "derived-from"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="derived-from"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. Composition.relatesTo:derivedFrom.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
92. Composition.relatesTo:specificationOf
Slice NamespecificationOf
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
94. Composition.relatesTo:specificationOf.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. Composition.relatesTo:specificationOf.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
98. Composition.relatesTo:specificationOf.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Typehttp://terminology.hl7.org/ValueSet/artifact-relationship-type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "specification-of"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="specification-of"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. Composition.relatesTo:specificationOf.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
102. Composition.relatesTo:dependsOn
Slice NamedependsOn
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
104. Composition.relatesTo:dependsOn.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. Composition.relatesTo:dependsOn.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
108. Composition.relatesTo:dependsOn.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Typehttp://terminology.hl7.org/ValueSet/artifact-relationship-type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "depends-on"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="depends-on"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. Composition.relatesTo:dependsOn.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
112. Composition.relatesTo:supportedWith
Slice NamesupportedWith
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
114. Composition.relatesTo:supportedWith.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. Composition.relatesTo:supportedWith.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
118. Composition.relatesTo:supportedWith.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Typehttp://terminology.hl7.org/ValueSet/artifact-relationship-type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "supported-with"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="supported-with"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. Composition.relatesTo:supportedWith.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
122. Composition.relatesTo:similarTo
Slice NamesimilarTo
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
124. Composition.relatesTo:similarTo.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
126. Composition.relatesTo:similarTo.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
128. Composition.relatesTo:similarTo.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Typehttp://terminology.hl7.org/ValueSet/artifact-relationship-type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "similar-to"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="similar-to"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
130. Composition.relatesTo:similarTo.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
132. Composition.section
Definition

The root of the sections that make up the composition.

ShortComposition is broken into sections
Control10..1*
This element is affected by the following invariants: cmp-3
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if no entries are included (emptyReason.empty() or entry.empty())
cmp-3: If attester exists then the Composition either needs a text or a section (%resource.attester.exists() implies(text.exists() or section.exists()))
ele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

134. Composition.section.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()))
SlicingThis element introduces a set of slices on Composition.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
136. Composition.section.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
138. Composition.section.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
140. Composition.section:intervention
Slice Nameintervention
Definition

The root of the sections that make up the composition.

ShortComposition is broken into sections
Control10..1*
This element is affected by the following invariants: cmp-3
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if no entries are included (emptyReason.empty() or entry.empty())
cmp-3: If attester exists then the Composition either needs a text or a section (%resource.attester.exists() implies(text.exists() or section.exists()))
ele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
142. Composition.section:intervention.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()))
SlicingThis element introduces a set of slices on Composition.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
144. Composition.section:intervention.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"
}
<title value="6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. Composition.section:intervention.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Trial interventions are all pre-specified investigational and noninvestigational medicinal products, medical devices or other interventions intended for the participants during the trial. The investigational trial intervention is the product used in the trial as part of trial objectives. Description of the investigational trial intervention is provided in Section 6.1 Description of Trial Intervention. Other trial interventions that are not part of trial objectives or do not have an investigational role in this trial are described in Section 6.9 Description of Noninvestigational Trial Interventions. Any regional requirements should be noted in the appropriate subsections. Provide an overview of investigational and noninvestigational trial interventions. Classify the trial intervention as IMP, NIMP/AxMP designations based on trial design and regional requirements. Consider an optional table with 12 columns (Arm Name, Arm Type, Intervention Name, Intervention Type, Pharmaceutical Dose Form, Dosage Strength(s), Dosage Level(s), Route of Administration, Regimen/Treatment Period/Vaccination Regimen, Use, IMP/NIMP, Sourcing).


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
148. Composition.section:intervention.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
150. Composition.section:intervention.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control100..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
152. Composition.section:intervention.section.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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
154. Composition.section:intervention.section.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
156. Composition.section:intervention.section.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
158. Composition.section:intervention.section:description
Slice Namedescription
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
160. Composition.section:intervention.section:description.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
162. Composition.section:intervention.section:description.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.1 Description of Investigational Trial Intervention"
}
<title value="6.1 Description of Investigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
164. Composition.section:intervention.section:description.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe the investigational trial intervention to be administered in each arm of the trial and for each period of the trial including route and mode of administration, dose, dosage regimen, duration of intervention, use, packaging and labelling. Refer to approved regional labelling, as appropriate. For investigational drug/device combination products, include details on the configuration and use of the device and device manufacturer. A device user manual may be referenced in this section. Entries should Reference ConceptualExposureDefinition Profile of Group Resource.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
166. Composition.section:intervention.section:description.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(ConceptualExposureDefinition, Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
168. Composition.section:intervention.section:rationale
Slice Namerationale
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
170. Composition.section:intervention.section:rationale.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
172. Composition.section:intervention.section:rationale.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.2 Rationale for Investigational Trial Intervention Dose and Regimen"
}
<title value="6.2 Rationale for Investigational Trial Intervention Dose and Regimen"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
174. Composition.section:intervention.section:rationale.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Provide a rationale for the selection of the dose(s) or dose range, pharmaceutical dose form, route of administration, and dosing regimen of the investigational trial intervention, as applicable. This rationale should include relevant results from nonclinical studies and clinical trials that support selection of the dose and regimen. Discuss impact of differences in trial population characteristics (e.g., age, sex, race) which could lead to differences in pharmacokinetics and pharmacodynamics in this trial as compared to previous trials. If applicable, justify any differences in dose regimen or therapeutic use relative to approved labelling. Describe prior trials and other information that support the dose and/or dose regimen of the investigational trial intervention. Include a rationale for prospective dose adjustments incorporated in the trial, if any. Entries should Reference ConceptualExposureDefinition Profile of Group Resource.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
176. Composition.section:intervention.section:rationale.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(ConceptualExposureDefinition, Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
178. Composition.section:intervention.section:dosingAdministration
Slice NamedosingAdministration
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
180. Composition.section:intervention.section:dosingAdministration.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
182. Composition.section:intervention.section:dosingAdministration.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.3 Investigational Trial Intervention Administration"
}
<title value="6.3 Investigational Trial Intervention Administration"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
184. Composition.section:intervention.section:dosingAdministration.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe the detailed procedures for administration of each participant’s dose of each investigational trial intervention. This may include the timing of dosing (e.g., time of day, interval), the duration (e.g., the length of time participants will be administered the investigational trial intervention), and the timing of dosing relative to meals. Include any specific instructions on who, when or how to prepare and take the dose(s) and how to handle any delayed or missed doses. Dose escalation or cohort expansion as part of the overall design should be covered in Section 4.1 Description of Trial Design. Entries should Reference ActivityDefinition Resource.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
186. Composition.section:intervention.section:dosingAdministration.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(ActivityDefinition, Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
188. Composition.section:intervention.section:doseModification
Slice NamedoseModification
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
190. Composition.section:intervention.section:doseModification.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
192. Composition.section:intervention.section:doseModification.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.4 Investigational Trial Intervention Dose Modification"
}
<title value="6.4 Investigational Trial Intervention Dose Modification"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
194. Composition.section:intervention.section:doseModification.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

For each participant, describe any dose modifications allowed, including conditions for such dose modifications, particularly regarding failure to respond or safety concerns. State any minimum period required before a participant’s dose might be raised to the next higher dose or dose range. Include whether it is permissible to start and stop treatment and how dose reductions (if permitted) are to be managed. Information on stopping investigational trial intervention for participants due to safety/other reasons should be described in Section 7 Participant Discontinuation of Trial Intervention and Discontinuation or Withdrawal from Trial. Entries should Reference ActivityDefinition Resource.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
196. Composition.section:intervention.section:doseModification.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(ActivityDefinition, Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
198. Composition.section:intervention.section:treatmentOfOverdose
Slice NametreatmentOfOverdose
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
200. Composition.section:intervention.section:treatmentOfOverdose.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
202. Composition.section:intervention.section:treatmentOfOverdose.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.5 Management of Investigational Trial Intervention Overdose"
}
<title value="6.5 Management of Investigational Trial Intervention Overdose"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
204. Composition.section:intervention.section:treatmentOfOverdose.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe what is meant by investigational trial intervention overdose. Provide any available information on managing the overdose and ensure it is consistent with the Investigator’s Brochure or product labelling. Cross reference these documents as applicable. Entries should Reference ActivityDefinition Resource or PlanDefinition Resource.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
206. Composition.section:intervention.section:treatmentOfOverdose.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(ActivityDefinition, PlanDefinition, Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
208. Composition.section:intervention.section:preparation
Slice Namepreparation
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
210. Composition.section:intervention.section:preparation.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
212. Composition.section:intervention.section:preparation.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.6 Preparation, Storage, Handling and Accountability of Investigational Trial Intervention"
}
<title value="6.6 Preparation, Storage, Handling and Accountability of Investigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
214. Composition.section:intervention.section:preparation.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

No text is intended here (heading only).


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
216. Composition.section:intervention.section:preparation.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
218. Composition.section:intervention.section:preparation.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control30..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.section.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
220. Composition.section:intervention.section:preparation.section.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
222. Composition.section:intervention.section:preparation.section.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
224. Composition.section:intervention.section:preparation.section.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
226. Composition.section:intervention.section:preparation.section:preparationIntervention
Slice NamepreparationIntervention
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
228. Composition.section:intervention.section:preparation.section:preparationIntervention.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
230. Composition.section:intervention.section:preparation.section:preparationIntervention.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.6.1 Preparation of Investigational Trial Intervention"
}
<title value="6.6.1 Preparation of Investigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
232. Composition.section:intervention.section:preparation.section:preparationIntervention.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe any preparation of the investigational trial intervention, and when necessary, who should prepare it. When applicable, describe the maximum hold time once thawed/mixed before administration. Include thawing, diluting, mixing, and reconstitution/preparation instructions. For drug/device combination products, include any relevant assembly or use instructions and reference the package insert that is provided separately. If the instructions are lengthy or complicated, it is acceptable to reference the package insert (if applicable) or include instructions in separate documents provided to the site (e.g., a pharmacy manual and reference the separate documents.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
234. Composition.section:intervention.section:preparation.section:preparationIntervention.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
236. Composition.section:intervention.section:preparation.section:storageHandling
Slice NamestorageHandling
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
238. Composition.section:intervention.section:preparation.section:storageHandling.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
240. Composition.section:intervention.section:preparation.section:storageHandling.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.6.2 Storage and Handling of Investigational Trial Intervention"
}
<title value="6.6.2 Storage and Handling of Investigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
242. Composition.section:intervention.section:preparation.section:storageHandling.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe storage and handling requirements (e.g., protection from light, temperature, humidity) for the investigational trial intervention(s). For trials in which multi-dose vials are utilised, provide additional information regarding stability and expiration time after initial use (e.g., if the seal is broken). Explain how the investigational trial intervention will be provided to the Investigator. If applicable, include details about kits, packaging, or other material of the investigational trial intervention for blinding purposes. If the instructions are lengthy or complicated, it is acceptable to reference the package insert (if applicable) or include instructions in separate documents provided to the site (e.g., a pharmacy manual) and reference the separate documents.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
244. Composition.section:intervention.section:preparation.section:storageHandling.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
246. Composition.section:intervention.section:preparation.section:accountability
Slice Nameaccountability
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
248. Composition.section:intervention.section:preparation.section:accountability.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
250. Composition.section:intervention.section:preparation.section:accountability.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.6.3 Accountability of Investigational Trial Intervention"
}
<title value="6.6.3 Accountability of Investigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
252. Composition.section:intervention.section:preparation.section:accountability.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe the accountability method, including: • how the investigational trial intervention will be distributed • who will distribute the investigational trial intervention • participation of a drug storage repository or pharmacy, if applicable • plans for disposal or return of unused product • if applicable, plans for reconciliation of investigational trial intervention


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
254. Composition.section:intervention.section:preparation.section:accountability.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
256. Composition.section:intervention.section:assignmentAndBlinding
Slice NameassignmentAndBlinding
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
258. Composition.section:intervention.section:assignmentAndBlinding.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
260. Composition.section:intervention.section:assignmentAndBlinding.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.7 Investigational Trial Intervention Assignment, Randomisation and Blinding"
}
<title value="6.7 Investigational Trial Intervention Assignment, Randomisation and Blinding"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
262. Composition.section:intervention.section:assignmentAndBlinding.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

No text is intended here (heading only).


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
264. Composition.section:intervention.section:assignmentAndBlinding.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
266. Composition.section:intervention.section:assignmentAndBlinding.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control40..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.section.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
268. Composition.section:intervention.section:assignmentAndBlinding.section.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
270. Composition.section:intervention.section:assignmentAndBlinding.section.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
272. Composition.section:intervention.section:assignmentAndBlinding.section.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
274. Composition.section:intervention.section:assignmentAndBlinding.section:assignment
Slice Nameassignment
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
276. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
278. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.7.1 Participant Assignment to Investigational Trial Intervention"
}
<title value="6.7.1 Participant Assignment to Investigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
280. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

State that at enrollment, participant identification codes should be assigned. Describe the method of assigning participants to investigational trial intervention without being so specific that blinding or randomisation might be compromised. If assignment to investigational trial intervention is by randomisation, describe when randomisation occurs relative to screening. If adaptive randomisation or other methods of covariate balancing/minimisation are employed, include a cross reference to the methods of analysis in Section 10 Statistical Considerations. As applicable, details regarding the implementation of procedures to minimise bias should be described.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
282. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
284. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation
Slice Namerandomisation
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
286. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
288. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.7.2 Randomisation"
}
<title value="6.7.2 Randomisation"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
290. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe the randomisation procedures (e.g., central randomisation procedures), the method used to generate the randomisation schedule (e.g., computer generated), the source of the randomisation schedule (e.g., sponsor, investigator, or other), and whether IxRS will be used. To maintain the integrity of the blinding, do not include the block size.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
292. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
294. Composition.section:intervention.section:assignmentAndBlinding.section:blinding
Slice Nameblinding
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
296. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
298. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.7.3 Measures to Maintain Blinding"
}
<title value="6.7.3 Measures to Maintain Blinding"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
300. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe measures that will be used to maintain blinding: • The investigational trial interventions are as indistinguishable as possible • Plans for the maintenance of randomisation codes and appropriate blinding for the trial • Procedures for planned (e.g., interim analysis) and unintentional (e.g., breach of procedure) breaking of randomisation codes. For unplanned but intentional actions (e.g., safety events), refer to Section 6.7.4 Emergency Unblinding at the Site. If the trial allows for some investigators or other designated staff to remain unblinded (e.g., to allow them to adjust investigational trial intervention), the means of maintaining the blinding for other investigators or staff should be explained. Measures to prevent unblinding by laboratory measurements or while performing study assessments, if used, should be described.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
302. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
304. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding
Slice Nameunblinding
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
306. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
308. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.7.4 Emergency Unblinding at the Site"
}
<title value="6.7.4 Emergency Unblinding at the Site"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
310. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe the criteria for breaking the trial blind or participant code. Describe the circumstances in which the blinding would be broken for an individual or for all participants and who has responsibility. Include the procedure for emergency unblinding such as via IxRS or code envelopes as well as documentation of unblinding. Indicate to whom the intentional and unintentional unblinding should be reported.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
312. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
314. Composition.section:intervention.section:adherence
Slice Nameadherence
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
316. Composition.section:intervention.section:adherence.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
318. Composition.section:intervention.section:adherence.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.8 Investigational Trial Intervention Adherence"
}
<title value="6.8 Investigational Trial Intervention Adherence"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
320. Composition.section:intervention.section:adherence.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe the measures to monitor and document participants’ adherence with investigational trial intervention (e.g., trial intervention accountability records, diary cards, or investigational trial intervention concentration measurements). List what documents are mandatory to complete (e.g., participant drug log) and what source data/records will be used to document investigational trial intervention adherence.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
322. Composition.section:intervention.section:adherence.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
324. Composition.section:intervention.section:noninvestigationalTherapy
Slice NamenoninvestigationalTherapy
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
326. Composition.section:intervention.section:noninvestigationalTherapy.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
328. Composition.section:intervention.section:noninvestigationalTherapy.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.9 Description of Noninvestigational Trial Intervention"
}
<title value="6.9 Description of Noninvestigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
330. Composition.section:intervention.section:noninvestigationalTherapy.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

As stated in Section 6 Trial Intervention and Concomitant Therapy, noninvestigational interventions are pre-specified products used in the trial but are not part of trial objectives and hence, are not investigational trial interventions.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
332. Composition.section:intervention.section:noninvestigationalTherapy.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
334. Composition.section:intervention.section:noninvestigationalTherapy.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.section.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
336. Composition.section:intervention.section:noninvestigationalTherapy.section.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
338. Composition.section:intervention.section:noninvestigationalTherapy.section.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
340. Composition.section:intervention.section:noninvestigationalTherapy.section.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
342. Composition.section:intervention.section:noninvestigationalTherapy.section:background
Slice Namebackground
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
344. Composition.section:intervention.section:noninvestigationalTherapy.section:background.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
346. Composition.section:intervention.section:noninvestigationalTherapy.section:background.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.9.1 Background Trial Intervention"
}
<title value="6.9.1 Background Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
348. Composition.section:intervention.section:noninvestigationalTherapy.section:background.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe any background intervention(s), including administration and any conditions for use.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
350. Composition.section:intervention.section:noninvestigationalTherapy.section:background.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
352. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue
Slice Namerescue
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
354. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
356. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.9.2 Rescue Therapy"
}
<title value="6.9.2 Rescue Therapy"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
358. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

List all permitted rescue medications, treatments, and/or procedures, including any relevant instructions on administration and any conditions of use. If administration of rescue therapy leads to the temporary discontinuation of trial intervention or a participant’s withdrawal from the trial, refer to Section 7 Participant Discontinuation of Trial Intervention and Discontinuation or Withdrawal from Trial.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
360. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
362. Composition.section:intervention.section:noninvestigationalTherapy.section:other
Slice Nameother
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
364. Composition.section:intervention.section:noninvestigationalTherapy.section:other.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
366. Composition.section:intervention.section:noninvestigationalTherapy.section:other.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.9.3 Other Noninvestigational Trial Intervention"
}
<title value="6.9.3 Other Noninvestigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
368. Composition.section:intervention.section:noninvestigationalTherapy.section:other.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

If applicable, describe the use of any other noninvestigational trial intervention, e.g., challenge agents or diagnostics.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
370. Composition.section:intervention.section:noninvestigationalTherapy.section:other.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
372. Composition.section:intervention.section:concomitantTherapy
Slice NameconcomitantTherapy
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
374. Composition.section:intervention.section:concomitantTherapy.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
376. Composition.section:intervention.section:concomitantTherapy.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.10 Concomitant Therapy"
}
<title value="6.10 Concomitant Therapy"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
378. Composition.section:intervention.section:concomitantTherapy.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Specify the concomitant medications, supplements, complementary and alternative therapies, treatments, and/or procedures which are prohibited or permitted during the trial and include details about when the information will be collected (e.g., during screening, at each visit). When appropriate to separate the content, subheadings may be used.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
380. Composition.section:intervention.section:concomitantTherapy.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
382. Composition.section:intervention.section:concomitantTherapy.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.section.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
384. Composition.section:intervention.section:concomitantTherapy.section.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
386. Composition.section:intervention.section:concomitantTherapy.section.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
388. Composition.section:intervention.section:concomitantTherapy.section.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
390. Composition.section:intervention.section:concomitantTherapy.section:prohibited
Slice Nameprohibited
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
392. Composition.section:intervention.section:concomitantTherapy.section:prohibited.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
394. Composition.section:intervention.section:concomitantTherapy.section:prohibited.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.10.1 Prohibited Concomitant Therapy"
}
<title value="6.10.1 Prohibited Concomitant Therapy"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
396. Composition.section:intervention.section:concomitantTherapy.section:prohibited.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

If applicable, describe any prohibited concomitant therapy.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
398. Composition.section:intervention.section:concomitantTherapy.section:prohibited.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
400. Composition.section:intervention.section:concomitantTherapy.section:permitted
Slice Namepermitted
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
402. Composition.section:intervention.section:concomitantTherapy.section:permitted.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.


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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
404. Composition.section:intervention.section:concomitantTherapy.section:permitted.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.10.2 Permitted Concomitant Therapy"
}
<title value="6.10.2 Permitted Concomitant Therapy"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
406. Composition.section:intervention.section:concomitantTherapy.section:permitted.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

If applicable, describe any permitted concomitant therapy.


Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control10..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
408. Composition.section:intervention.section:concomitantTherapy.section:permitted.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

See the documentation on how to interpret the contents of this table

0. Composition
2. Composition.type
4. Composition.type.coding
Control1..1
Pattern Value
{
  "system" : "http://loinc.org",
  "code" : "35528-9",
  "display" : "Clinical trial protocol Clinical trial protocol"
}
<coding>
  <system value="http://loinc.org"/>
  <code value="35528-9"/>
  <display value="Clinical trial protocol Clinical trial protocol"/>
</coding>
6. Composition.type.text
Pattern Value
{
  "text" : "CeSHarP Report"
}
<text value="CeSHarP Report"/>
8. Composition.category
SlicingThis element introduces a set of slices on Composition.category. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ text
10. Composition.category:intervention
Slice Nameintervention
Control0..1
12. Composition.category:intervention.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218560",
  "display" : "ICH M11 Protocol Section 6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218560"/>
  <display value="ICH M11 Protocol Section 6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"/>
</coding>
14. Composition.category:intervention.text
Control1..?
Pattern Value
{
  "text" : "section6-trial-intervention"
}
<text value="section6-trial-intervention"/>
16. Composition.section
Control1..1
SlicingThis element introduces a set of slices on Composition.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

18. Composition.section:intervention
Slice Nameintervention
Control1..1
Must Supporttrue
20. Composition.section:intervention.title
Pattern Value
{
  "title" : "6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"
}
<title value="6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"/>
22. Composition.section:intervention.code
24. Composition.section:intervention.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218560",
  "display" : "ICH M11 Protocol Section 6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218560"/>
  <display value="ICH M11 Protocol Section 6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"/>
</coding>
26. Composition.section:intervention.code.text
Control1..?
Pattern Value
{
  "text" : "section6-trial-intervention"
}
<text value="section6-trial-intervention"/>
28. Composition.section:intervention.text
Comments

Trial interventions are all pre-specified investigational and noninvestigational medicinal products, medical devices or other interventions intended for the participants during the trial. The investigational trial intervention is the product used in the trial as part of trial objectives. Description of the investigational trial intervention is provided in Section 6.1 Description of Trial Intervention. Other trial interventions that are not part of trial objectives or do not have an investigational role in this trial are described in Section 6.9 Description of Noninvestigational Trial Interventions. Any regional requirements should be noted in the appropriate subsections. Provide an overview of investigational and noninvestigational trial interventions. Classify the trial intervention as IMP, NIMP/AxMP designations based on trial design and regional requirements. Consider an optional table with 12 columns (Arm Name, Arm Type, Intervention Name, Intervention Type, Pharmaceutical Dose Form, Dosage Strength(s), Dosage Level(s), Route of Administration, Regimen/Treatment Period/Vaccination Regimen, Use, IMP/NIMP, Sourcing).

30. Composition.section:intervention.section
Control10..?
SlicingThis element introduces a set of slices on Composition.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
32. Composition.section:intervention.section:description
Slice Namedescription
Control1..1
TypeBackboneElement
Must Supporttrue
34. Composition.section:intervention.section:description.title
Pattern Value
{
  "title" : "6.1 Description of Investigational Trial Intervention"
}
<title value="6.1 Description of Investigational Trial Intervention"/>
36. Composition.section:intervention.section:description.code
38. Composition.section:intervention.section:description.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218561",
  "display" : "ICH M11 Protocol Section 6.1 Description of Investigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218561"/>
  <display value="ICH M11 Protocol Section 6.1 Description of Investigational Trial Intervention"/>
</coding>
40. Composition.section:intervention.section:description.code.text
Control1..?
Pattern Value
{
  "text" : "section6.1-description-of-trial-intervention"
}
<text value="section6.1-description-of-trial-intervention"/>
42. Composition.section:intervention.section:description.text
Comments

Describe the investigational trial intervention to be administered in each arm of the trial and for each period of the trial including route and mode of administration, dose, dosage regimen, duration of intervention, use, packaging and labelling. Refer to approved regional labelling, as appropriate. For investigational drug/device combination products, include details on the configuration and use of the device and device manufacturer. A device user manual may be referenced in this section. Entries should Reference ConceptualExposureDefinition Profile of Group Resource.

Control1..?
44. Composition.section:intervention.section:description.entry
TypeReference(ConceptualExposureDefinition)
46. Composition.section:intervention.section:rationale
Slice Namerationale
Control1..1
TypeBackboneElement
Must Supporttrue
48. Composition.section:intervention.section:rationale.title
Pattern Value
{
  "title" : "6.2 Rationale for Investigational Trial Intervention Dose and Regimen"
}
<title value="6.2 Rationale for Investigational Trial Intervention Dose and Regimen"/>
50. Composition.section:intervention.section:rationale.code
52. Composition.section:intervention.section:rationale.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218562",
  "display" : "ICH M11 Protocol Section 6.2 Rationale for Investigational Trial Intervention Dose and Regimen"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218562"/>
  <display value="ICH M11 Protocol Section 6.2 Rationale for Investigational Trial Intervention Dose and Regimen"/>
</coding>
54. Composition.section:intervention.section:rationale.code.text
Control1..?
Pattern Value
{
  "text" : "section6.2-rationale-for-trial-intervention-regimen"
}
<text value="section6.2-rationale-for-trial-intervention-regimen"/>
56. Composition.section:intervention.section:rationale.text
Comments

Provide a rationale for the selection of the dose(s) or dose range, pharmaceutical dose form, route of administration, and dosing regimen of the investigational trial intervention, as applicable. This rationale should include relevant results from nonclinical studies and clinical trials that support selection of the dose and regimen. Discuss impact of differences in trial population characteristics (e.g., age, sex, race) which could lead to differences in pharmacokinetics and pharmacodynamics in this trial as compared to previous trials. If applicable, justify any differences in dose regimen or therapeutic use relative to approved labelling. Describe prior trials and other information that support the dose and/or dose regimen of the investigational trial intervention. Include a rationale for prospective dose adjustments incorporated in the trial, if any. Entries should Reference ConceptualExposureDefinition Profile of Group Resource.

Control1..?
58. Composition.section:intervention.section:rationale.entry
TypeReference(ConceptualExposureDefinition)
60. Composition.section:intervention.section:dosingAdministration
Slice NamedosingAdministration
Control1..1
TypeBackboneElement
Must Supporttrue
62. Composition.section:intervention.section:dosingAdministration.title
Pattern Value
{
  "title" : "6.3 Investigational Trial Intervention Administration"
}
<title value="6.3 Investigational Trial Intervention Administration"/>
64. Composition.section:intervention.section:dosingAdministration.code
66. Composition.section:intervention.section:dosingAdministration.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218563",
  "display" : "ICH M11 Protocol Section 6.3 Investigational Trial Intervention Administration"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218563"/>
  <display value="ICH M11 Protocol Section 6.3 Investigational Trial Intervention Administration"/>
</coding>
68. Composition.section:intervention.section:dosingAdministration.code.text
Control1..?
Pattern Value
{
  "text" : "section6.3-dosing-and-administration"
}
<text value="section6.3-dosing-and-administration"/>
70. Composition.section:intervention.section:dosingAdministration.text
Comments

Describe the detailed procedures for administration of each participant’s dose of each investigational trial intervention. This may include the timing of dosing (e.g., time of day, interval), the duration (e.g., the length of time participants will be administered the investigational trial intervention), and the timing of dosing relative to meals. Include any specific instructions on who, when or how to prepare and take the dose(s) and how to handle any delayed or missed doses. Dose escalation or cohort expansion as part of the overall design should be covered in Section 4.1 Description of Trial Design. Entries should Reference ActivityDefinition Resource.

Control1..?
72. Composition.section:intervention.section:dosingAdministration.entry
TypeReference(ActivityDefinition)
74. Composition.section:intervention.section:doseModification
Slice NamedoseModification
Control1..1
TypeBackboneElement
Must Supporttrue
76. Composition.section:intervention.section:doseModification.title
Pattern Value
{
  "title" : "6.4 Investigational Trial Intervention Dose Modification"
}
<title value="6.4 Investigational Trial Intervention Dose Modification"/>
78. Composition.section:intervention.section:doseModification.code
80. Composition.section:intervention.section:doseModification.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218564",
  "display" : "ICH M11 Protocol Section 6.4 Investigational Trial Intervention Dose Modification"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218564"/>
  <display value="ICH M11 Protocol Section 6.4 Investigational Trial Intervention Dose Modification"/>
</coding>
82. Composition.section:intervention.section:doseModification.code.text
Control1..?
Pattern Value
{
  "text" : "section6.4-dose-modification"
}
<text value="section6.4-dose-modification"/>
84. Composition.section:intervention.section:doseModification.text
Comments

For each participant, describe any dose modifications allowed, including conditions for such dose modifications, particularly regarding failure to respond or safety concerns. State any minimum period required before a participant’s dose might be raised to the next higher dose or dose range. Include whether it is permissible to start and stop treatment and how dose reductions (if permitted) are to be managed. Information on stopping investigational trial intervention for participants due to safety/other reasons should be described in Section 7 Participant Discontinuation of Trial Intervention and Discontinuation or Withdrawal from Trial. Entries should Reference ActivityDefinition Resource.

Control1..?
86. Composition.section:intervention.section:doseModification.entry
TypeReference(ActivityDefinition)
88. Composition.section:intervention.section:treatmentOfOverdose
Slice NametreatmentOfOverdose
Control1..1
TypeBackboneElement
Must Supporttrue
90. Composition.section:intervention.section:treatmentOfOverdose.title
Pattern Value
{
  "title" : "6.5 Management of Investigational Trial Intervention Overdose"
}
<title value="6.5 Management of Investigational Trial Intervention Overdose"/>
92. Composition.section:intervention.section:treatmentOfOverdose.code
94. Composition.section:intervention.section:treatmentOfOverdose.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218565",
  "display" : "ICH M11 Protocol Section 6.5 Management of Investigational Trial Intervention Overdose"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218565"/>
  <display value="ICH M11 Protocol Section 6.5 Management of Investigational Trial Intervention Overdose"/>
</coding>
96. Composition.section:intervention.section:treatmentOfOverdose.code.text
Control1..?
Pattern Value
{
  "text" : "section6.5-management-of-overdose"
}
<text value="section6.5-management-of-overdose"/>
98. Composition.section:intervention.section:treatmentOfOverdose.text
Comments

Describe what is meant by investigational trial intervention overdose. Provide any available information on managing the overdose and ensure it is consistent with the Investigator’s Brochure or product labelling. Cross reference these documents as applicable. Entries should Reference ActivityDefinition Resource or PlanDefinition Resource.

Control1..?
100. Composition.section:intervention.section:treatmentOfOverdose.entry
TypeReference(ActivityDefinition, PlanDefinition)
102. Composition.section:intervention.section:preparation
Slice Namepreparation
Control1..1
TypeBackboneElement
Must Supporttrue
104. Composition.section:intervention.section:preparation.title
Pattern Value
{
  "title" : "6.6 Preparation, Storage, Handling and Accountability of Investigational Trial Intervention"
}
<title value="6.6 Preparation, Storage, Handling and Accountability of Investigational Trial Intervention"/>
106. Composition.section:intervention.section:preparation.code
108. Composition.section:intervention.section:preparation.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218566",
  "display" : "ICH M11 Protocol Section 6.6 Preparation, Storage, Handling and Accountability of Investigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218566"/>
  <display value="ICH M11 Protocol Section 6.6 Preparation, Storage, Handling and Accountability of Investigational Trial Intervention"/>
</coding>
110. Composition.section:intervention.section:preparation.code.text
Control1..?
Pattern Value
{
  "text" : "section6.6-preparation-storage-handling"
}
<text value="section6.6-preparation-storage-handling"/>
112. Composition.section:intervention.section:preparation.text
Comments

No text is intended here (heading only).

114. Composition.section:intervention.section:preparation.section
Control3..?
SlicingThis element introduces a set of slices on Composition.section.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
116. Composition.section:intervention.section:preparation.section:preparationIntervention
Slice NamepreparationIntervention
Control1..1
TypeBackboneElement
Must Supporttrue
118. Composition.section:intervention.section:preparation.section:preparationIntervention.title
Pattern Value
{
  "title" : "6.6.1 Preparation of Investigational Trial Intervention"
}
<title value="6.6.1 Preparation of Investigational Trial Intervention"/>
120. Composition.section:intervention.section:preparation.section:preparationIntervention.code
122. Composition.section:intervention.section:preparation.section:preparationIntervention.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218567",
  "display" : "ICH M11 Protocol Section 6.6.1 Preparation of Investigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218567"/>
  <display value="ICH M11 Protocol Section 6.6.1 Preparation of Investigational Trial Intervention"/>
</coding>
124. Composition.section:intervention.section:preparation.section:preparationIntervention.code.text
Control1..?
Pattern Value
{
  "text" : "section6.6.1-preparation"
}
<text value="section6.6.1-preparation"/>
126. Composition.section:intervention.section:preparation.section:preparationIntervention.text
Comments

Describe any preparation of the investigational trial intervention, and when necessary, who should prepare it. When applicable, describe the maximum hold time once thawed/mixed before administration. Include thawing, diluting, mixing, and reconstitution/preparation instructions. For drug/device combination products, include any relevant assembly or use instructions and reference the package insert that is provided separately. If the instructions are lengthy or complicated, it is acceptable to reference the package insert (if applicable) or include instructions in separate documents provided to the site (e.g., a pharmacy manual and reference the separate documents.

Control1..?
128. Composition.section:intervention.section:preparation.section:storageHandling
Slice NamestorageHandling
Control1..1
TypeBackboneElement
Must Supporttrue
130. Composition.section:intervention.section:preparation.section:storageHandling.title
Pattern Value
{
  "title" : "6.6.2 Storage and Handling of Investigational Trial Intervention"
}
<title value="6.6.2 Storage and Handling of Investigational Trial Intervention"/>
132. Composition.section:intervention.section:preparation.section:storageHandling.code
134. Composition.section:intervention.section:preparation.section:storageHandling.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218568",
  "display" : "ICH M11 Protocol Section 6.6.2 Storage and Handling of Investigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218568"/>
  <display value="ICH M11 Protocol Section 6.6.2 Storage and Handling of Investigational Trial Intervention"/>
</coding>
136. Composition.section:intervention.section:preparation.section:storageHandling.code.text
Control1..?
Pattern Value
{
  "text" : "section6.6.2-storage-handling"
}
<text value="section6.6.2-storage-handling"/>
138. Composition.section:intervention.section:preparation.section:storageHandling.text
Comments

Describe storage and handling requirements (e.g., protection from light, temperature, humidity) for the investigational trial intervention(s). For trials in which multi-dose vials are utilised, provide additional information regarding stability and expiration time after initial use (e.g., if the seal is broken). Explain how the investigational trial intervention will be provided to the Investigator. If applicable, include details about kits, packaging, or other material of the investigational trial intervention for blinding purposes. If the instructions are lengthy or complicated, it is acceptable to reference the package insert (if applicable) or include instructions in separate documents provided to the site (e.g., a pharmacy manual) and reference the separate documents.

Control1..?
140. Composition.section:intervention.section:preparation.section:accountability
Slice Nameaccountability
Control1..1
TypeBackboneElement
Must Supporttrue
142. Composition.section:intervention.section:preparation.section:accountability.title
Pattern Value
{
  "title" : "6.6.3 Accountability of Investigational Trial Intervention"
}
<title value="6.6.3 Accountability of Investigational Trial Intervention"/>
144. Composition.section:intervention.section:preparation.section:accountability.code
146. Composition.section:intervention.section:preparation.section:accountability.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218569",
  "display" : "ICH M11 Protocol Section 6.6.3 Accountability of Investigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218569"/>
  <display value="ICH M11 Protocol Section 6.6.3 Accountability of Investigational Trial Intervention"/>
</coding>
148. Composition.section:intervention.section:preparation.section:accountability.code.text
Control1..?
Pattern Value
{
  "text" : "section6.6.3-accountability"
}
<text value="section6.6.3-accountability"/>
150. Composition.section:intervention.section:preparation.section:accountability.text
Comments

Describe the accountability method, including: • how the investigational trial intervention will be distributed • who will distribute the investigational trial intervention • participation of a drug storage repository or pharmacy, if applicable • plans for disposal or return of unused product • if applicable, plans for reconciliation of investigational trial intervention

Control1..?
152. Composition.section:intervention.section:assignmentAndBlinding
Slice NameassignmentAndBlinding
Control1..1
TypeBackboneElement
Must Supporttrue
154. Composition.section:intervention.section:assignmentAndBlinding.title
Pattern Value
{
  "title" : "6.7 Investigational Trial Intervention Assignment, Randomisation and Blinding"
}
<title value="6.7 Investigational Trial Intervention Assignment, Randomisation and Blinding"/>
156. Composition.section:intervention.section:assignmentAndBlinding.code
158. Composition.section:intervention.section:assignmentAndBlinding.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218570",
  "display" : "ICH M11 Protocol Section 6.7 Investigational Trial Intervention Assignment, Randomisation and Blinding"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218570"/>
  <display value="ICH M11 Protocol Section 6.7 Investigational Trial Intervention Assignment, Randomisation and Blinding"/>
</coding>
160. Composition.section:intervention.section:assignmentAndBlinding.code.text
Control1..?
Pattern Value
{
  "text" : "section6.7-assignment-randomisation-blinding"
}
<text value="section6.7-assignment-randomisation-blinding"/>
162. Composition.section:intervention.section:assignmentAndBlinding.text
Comments

No text is intended here (heading only).

164. Composition.section:intervention.section:assignmentAndBlinding.section
Control4..?
SlicingThis element introduces a set of slices on Composition.section.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
166. Composition.section:intervention.section:assignmentAndBlinding.section:assignment
Slice Nameassignment
Control1..1
TypeBackboneElement
Must Supporttrue
168. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.title
Pattern Value
{
  "title" : "6.7.1 Participant Assignment to Investigational Trial Intervention"
}
<title value="6.7.1 Participant Assignment to Investigational Trial Intervention"/>
170. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.code
172. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218571",
  "display" : "ICH M11 Protocol Section 6.7.1 Participant Assignment to Investigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218571"/>
  <display value="ICH M11 Protocol Section 6.7.1 Participant Assignment to Investigational Trial Intervention"/>
</coding>
174. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.code.text
Control1..?
Pattern Value
{
  "text" : "section6.7.1-assignment"
}
<text value="section6.7.1-assignment"/>
176. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.text
Comments

State that at enrollment, participant identification codes should be assigned. Describe the method of assigning participants to investigational trial intervention without being so specific that blinding or randomisation might be compromised. If assignment to investigational trial intervention is by randomisation, describe when randomisation occurs relative to screening. If adaptive randomisation or other methods of covariate balancing/minimisation are employed, include a cross reference to the methods of analysis in Section 10 Statistical Considerations. As applicable, details regarding the implementation of procedures to minimise bias should be described.

Control1..?
178. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation
Slice Namerandomisation
Control0..1
TypeBackboneElement
Must Supporttrue
180. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.title
Pattern Value
{
  "title" : "6.7.2 Randomisation"
}
<title value="6.7.2 Randomisation"/>
182. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.code
184. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218572",
  "display" : "ICH M11 Protocol Section 6.7.2 Randomisation"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218572"/>
  <display value="ICH M11 Protocol Section 6.7.2 Randomisation"/>
</coding>
186. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.code.text
Control1..?
Pattern Value
{
  "text" : "section6.7.2-randomisation"
}
<text value="section6.7.2-randomisation"/>
188. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.text
Comments

Describe the randomisation procedures (e.g., central randomisation procedures), the method used to generate the randomisation schedule (e.g., computer generated), the source of the randomisation schedule (e.g., sponsor, investigator, or other), and whether IxRS will be used. To maintain the integrity of the blinding, do not include the block size.

Control1..?
190. Composition.section:intervention.section:assignmentAndBlinding.section:blinding
Slice Nameblinding
Control0..1
TypeBackboneElement
Must Supporttrue
192. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.title
Pattern Value
{
  "title" : "6.7.3 Measures to Maintain Blinding"
}
<title value="6.7.3 Measures to Maintain Blinding"/>
194. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.code
196. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218573",
  "display" : "ICH M11 Protocol Section 6.7.3 Measures to Maintain Blinding"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218573"/>
  <display value="ICH M11 Protocol Section 6.7.3 Measures to Maintain Blinding"/>
</coding>
198. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.code.text
Control1..?
Pattern Value
{
  "text" : "section6.7.3-blinding"
}
<text value="section6.7.3-blinding"/>
200. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.text
Comments

Describe measures that will be used to maintain blinding: • The investigational trial interventions are as indistinguishable as possible • Plans for the maintenance of randomisation codes and appropriate blinding for the trial • Procedures for planned (e.g., interim analysis) and unintentional (e.g., breach of procedure) breaking of randomisation codes. For unplanned but intentional actions (e.g., safety events), refer to Section 6.7.4 Emergency Unblinding at the Site. If the trial allows for some investigators or other designated staff to remain unblinded (e.g., to allow them to adjust investigational trial intervention), the means of maintaining the blinding for other investigators or staff should be explained. Measures to prevent unblinding by laboratory measurements or while performing study assessments, if used, should be described.

Control1..?
202. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding
Slice Nameunblinding
Control0..1
TypeBackboneElement
Must Supporttrue
204. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.title
Pattern Value
{
  "title" : "6.7.4 Emergency Unblinding at the Site"
}
<title value="6.7.4 Emergency Unblinding at the Site"/>
206. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.code
208. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218574",
  "display" : "ICH M11 Protocol Section 6.7.4 Emergency Unblinding at the Site"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218574"/>
  <display value="ICH M11 Protocol Section 6.7.4 Emergency Unblinding at the Site"/>
</coding>
210. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.code.text
Control1..?
Pattern Value
{
  "text" : "section6.7.4-unblinding"
}
<text value="section6.7.4-unblinding"/>
212. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.text
Comments

Describe the criteria for breaking the trial blind or participant code. Describe the circumstances in which the blinding would be broken for an individual or for all participants and who has responsibility. Include the procedure for emergency unblinding such as via IxRS or code envelopes as well as documentation of unblinding. Indicate to whom the intentional and unintentional unblinding should be reported.

Control1..?
214. Composition.section:intervention.section:adherence
Slice Nameadherence
Control1..1
TypeBackboneElement
Must Supporttrue
216. Composition.section:intervention.section:adherence.title
Pattern Value
{
  "title" : "6.8 Investigational Trial Intervention Adherence"
}
<title value="6.8 Investigational Trial Intervention Adherence"/>
218. Composition.section:intervention.section:adherence.code
220. Composition.section:intervention.section:adherence.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218575",
  "display" : "ICH M11 Protocol Section 6.8 Investigational Trial Intervention Adherence"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218575"/>
  <display value="ICH M11 Protocol Section 6.8 Investigational Trial Intervention Adherence"/>
</coding>
222. Composition.section:intervention.section:adherence.code.text
Control1..?
Pattern Value
{
  "text" : "section6.8-intervention-adherence"
}
<text value="section6.8-intervention-adherence"/>
224. Composition.section:intervention.section:adherence.text
Comments

Describe the measures to monitor and document participants’ adherence with investigational trial intervention (e.g., trial intervention accountability records, diary cards, or investigational trial intervention concentration measurements). List what documents are mandatory to complete (e.g., participant drug log) and what source data/records will be used to document investigational trial intervention adherence.

Control1..?
226. Composition.section:intervention.section:noninvestigationalTherapy
Slice NamenoninvestigationalTherapy
Control1..1
TypeBackboneElement
Must Supporttrue
228. Composition.section:intervention.section:noninvestigationalTherapy.title
Pattern Value
{
  "title" : "6.9 Description of Noninvestigational Trial Intervention"
}
<title value="6.9 Description of Noninvestigational Trial Intervention"/>
230. Composition.section:intervention.section:noninvestigationalTherapy.code
232. Composition.section:intervention.section:noninvestigationalTherapy.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218576",
  "display" : "ICH M11 Protocol Section 6.9 Description of Noninvestigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218576"/>
  <display value="ICH M11 Protocol Section 6.9 Description of Noninvestigational Trial Intervention"/>
</coding>
234. Composition.section:intervention.section:noninvestigationalTherapy.code.text
Control1..?
Pattern Value
{
  "text" : "section6.9-noninvestigational-interventions"
}
<text value="section6.9-noninvestigational-interventions"/>
236. Composition.section:intervention.section:noninvestigationalTherapy.text
Comments

As stated in Section 6 Trial Intervention and Concomitant Therapy, noninvestigational interventions are pre-specified products used in the trial but are not part of trial objectives and hence, are not investigational trial interventions.

Control1..?
238. Composition.section:intervention.section:noninvestigationalTherapy.section
SlicingThis element introduces a set of slices on Composition.section.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
240. Composition.section:intervention.section:noninvestigationalTherapy.section:background
Slice Namebackground
Control0..1
TypeBackboneElement
Must Supporttrue
242. Composition.section:intervention.section:noninvestigationalTherapy.section:background.title
Pattern Value
{
  "title" : "6.9.1 Background Trial Intervention"
}
<title value="6.9.1 Background Trial Intervention"/>
244. Composition.section:intervention.section:noninvestigationalTherapy.section:background.code
246. Composition.section:intervention.section:noninvestigationalTherapy.section:background.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218577",
  "display" : "ICH M11 Protocol Section 6.9.1 Background Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218577"/>
  <display value="ICH M11 Protocol Section 6.9.1 Background Trial Intervention"/>
</coding>
248. Composition.section:intervention.section:noninvestigationalTherapy.section:background.code.text
Control1..?
Pattern Value
{
  "text" : "section6.9.1-background-intervention"
}
<text value="section6.9.1-background-intervention"/>
250. Composition.section:intervention.section:noninvestigationalTherapy.section:background.text
Comments

Describe any background intervention(s), including administration and any conditions for use.

Control1..?
252. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue
Slice Namerescue
Control0..1
TypeBackboneElement
Must Supporttrue
254. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.title
Pattern Value
{
  "title" : "6.9.2 Rescue Therapy"
}
<title value="6.9.2 Rescue Therapy"/>
256. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.code
258. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218578",
  "display" : "ICH M11 Protocol Section 6.9.2 Rescue Therapy"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218578"/>
  <display value="ICH M11 Protocol Section 6.9.2 Rescue Therapy"/>
</coding>
260. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.code.text
Control1..?
Pattern Value
{
  "text" : "section6.9.2-rescue-therapy"
}
<text value="section6.9.2-rescue-therapy"/>
262. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.text
Comments

List all permitted rescue medications, treatments, and/or procedures, including any relevant instructions on administration and any conditions of use. If administration of rescue therapy leads to the temporary discontinuation of trial intervention or a participant’s withdrawal from the trial, refer to Section 7 Participant Discontinuation of Trial Intervention and Discontinuation or Withdrawal from Trial.

Control1..?
264. Composition.section:intervention.section:noninvestigationalTherapy.section:other
Slice Nameother
Control0..1
TypeBackboneElement
Must Supporttrue
266. Composition.section:intervention.section:noninvestigationalTherapy.section:other.title
Pattern Value
{
  "title" : "6.9.3 Other Noninvestigational Trial Intervention"
}
<title value="6.9.3 Other Noninvestigational Trial Intervention"/>
268. Composition.section:intervention.section:noninvestigationalTherapy.section:other.code
270. Composition.section:intervention.section:noninvestigationalTherapy.section:other.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218579",
  "display" : "ICH M11 Protocol Section 6.9.3 Other Noninvestigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218579"/>
  <display value="ICH M11 Protocol Section 6.9.3 Other Noninvestigational Trial Intervention"/>
</coding>
272. Composition.section:intervention.section:noninvestigationalTherapy.section:other.code.text
Control1..?
Pattern Value
{
  "text" : "section6.9.3-other-therapy"
}
<text value="section6.9.3-other-therapy"/>
274. Composition.section:intervention.section:noninvestigationalTherapy.section:other.text
Comments

If applicable, describe the use of any other noninvestigational trial intervention, e.g., challenge agents or diagnostics.

Control1..?
276. Composition.section:intervention.section:concomitantTherapy
Slice NameconcomitantTherapy
Control1..1
TypeBackboneElement
Must Supporttrue
278. Composition.section:intervention.section:concomitantTherapy.title
Pattern Value
{
  "title" : "6.10 Concomitant Therapy"
}
<title value="6.10 Concomitant Therapy"/>
280. Composition.section:intervention.section:concomitantTherapy.code
282. Composition.section:intervention.section:concomitantTherapy.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218580",
  "display" : "ICH M11 Protocol Section 6.10 Concomitant Therapy"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218580"/>
  <display value="ICH M11 Protocol Section 6.10 Concomitant Therapy"/>
</coding>
284. Composition.section:intervention.section:concomitantTherapy.code.text
Control1..?
Pattern Value
{
  "text" : "section6.10-concomitant-therapy"
}
<text value="section6.10-concomitant-therapy"/>
286. Composition.section:intervention.section:concomitantTherapy.text
Comments

Specify the concomitant medications, supplements, complementary and alternative therapies, treatments, and/or procedures which are prohibited or permitted during the trial and include details about when the information will be collected (e.g., during screening, at each visit). When appropriate to separate the content, subheadings may be used.

Control1..?
288. Composition.section:intervention.section:concomitantTherapy.section
SlicingThis element introduces a set of slices on Composition.section.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
290. Composition.section:intervention.section:concomitantTherapy.section:prohibited
Slice Nameprohibited
Control0..1
TypeBackboneElement
Must Supporttrue
292. Composition.section:intervention.section:concomitantTherapy.section:prohibited.title
Pattern Value
{
  "title" : "6.10.1 Prohibited Concomitant Therapy"
}
<title value="6.10.1 Prohibited Concomitant Therapy"/>
294. Composition.section:intervention.section:concomitantTherapy.section:prohibited.code
296. Composition.section:intervention.section:concomitantTherapy.section:prohibited.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218581",
  "display" : "ICH M11 Protocol Section 6.10.1 Prohibited Concomitant Therapy"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218581"/>
  <display value="ICH M11 Protocol Section 6.10.1 Prohibited Concomitant Therapy"/>
</coding>
298. Composition.section:intervention.section:concomitantTherapy.section:prohibited.code.text
Control1..?
Pattern Value
{
  "text" : "section6.10.1-prohibited-concomitant-therapy"
}
<text value="section6.10.1-prohibited-concomitant-therapy"/>
300. Composition.section:intervention.section:concomitantTherapy.section:prohibited.text
Comments

If applicable, describe any prohibited concomitant therapy.

Control1..?
302. Composition.section:intervention.section:concomitantTherapy.section:permitted
Slice Namepermitted
Control0..1
TypeBackboneElement
Must Supporttrue
304. Composition.section:intervention.section:concomitantTherapy.section:permitted.title
Pattern Value
{
  "title" : "6.10.2 Permitted Concomitant Therapy"
}
<title value="6.10.2 Permitted Concomitant Therapy"/>
306. Composition.section:intervention.section:concomitantTherapy.section:permitted.code
308. Composition.section:intervention.section:concomitantTherapy.section:permitted.code.coding
Control1..1
Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218582",
  "display" : "ICH M11 Protocol Section 6.10.2 Permitted Concomitant Therapy"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218582"/>
  <display value="ICH M11 Protocol Section 6.10.2 Permitted Concomitant Therapy"/>
</coding>
310. Composition.section:intervention.section:concomitantTherapy.section:permitted.code.text
Control1..?
Pattern Value
{
  "text" : "section6.10.2-permitted-concomitant-therapy"
}
<text value="section6.10.2-permitted-concomitant-therapy"/>
312. Composition.section:intervention.section:concomitantTherapy.section:permitted.text
Comments

If applicable, describe any permitted concomitant therapy.

Control1..?

See the documentation on how to interpret the contents of this table

0. Composition
Definition

Composition provides the structural backbone for assembling a set of healthcare-related information into a single logical package that provides a single coherent statement of meaning, establishes its own context and has traceability to the author who is making the statement.

ShortA set of resources composed into a single coherent clinical statement with clinical attestation
Comments

While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

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.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').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. Composition.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 resource id depends on the given use case.

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

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

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Composition.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. For DomainResources, if more than one implicitRules policy applies, additional policies may be conveyed using the additionalImplicitRules extension.

ShortA set of rules under which this content was created
Comments

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

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Composition.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|6.0.0-snapshot1)

IETF language tag for a human language

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

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

ShortText summary of the resource, for human interpretation
Comments

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

Control0..1
This element is affected by the following invariants: dom-6
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Composition.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. Contained resources may be a resource type defined in the FHIR specification, or an additional resource.

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

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

ShortAdditional content defined by implementations
Comments

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

Control0..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
16. Composition.extension:versionAlgorithm
Slice NameversionAlgorithm
Definition

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

ShortHow to compare versions
Comments

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

Control0..1
TypeExtension(Artifact Version Algorithm) (Extension Type: Choice of: string, Coding)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Composition.extension:experimental
Slice Nameexperimental
Definition

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

ShortFor testing purposes, not real usage
Control0..1
TypeExtension(Artifact Experimental) (Extension Type: boolean)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Composition.extension:description
Slice Namedescription
Definition

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

ShortNatural language description of the artifact
Comments

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

Control0..1
TypeExtension(Artifact Description) (Extension Type: markdown)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Composition.extension:purpose
Slice Namepurpose
Definition

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

ShortWhy this artifact is defined
Comments

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

Control0..1
TypeExtension(Artifact Purpose) (Extension Type: markdown)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Composition.extension:copyright
Slice Namecopyright
Definition

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

ShortUse and/or publishing restrictions
Comments

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

Control0..1
TypeExtension(Artifact Copyright) (Extension Type: markdown)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Composition.extension:copyrightLabel
Slice NamecopyrightLabel
Definition

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

ShortCopyright holder and year(s)
Comments

Defines the content expected to be rendered in all representations of the artifact. The (c) symbol should NOT be included in this string. It is expected to be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

Control0..1
TypeExtension(Artifact Copyright Label) (Extension Type: string)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Composition.extension:approvalDate
Slice NameapprovalDate
Definition

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

ShortWhen the artifact 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
TypeExtension(Artifact Approval Date) (Extension Type: date)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Composition.extension:lastReviewDate
Slice NamelastReviewDate
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 was approved by publisher
Comments

If specified, this date follows the original approval date.

Control0..1
TypeExtension(Artifact Last Review Date) (Extension Type: date)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Composition.extension:effectivePeriod
Slice NameeffectivePeriod
Definition

The period during which the artifact content was or is planned to be in active use.

ShortWhen the artifact is expected to be used
Comments

The effective period for an artifact determines when the content is applicable for usage and is independent of publication and review dates. For example, an artifact intended to be used for the year 2016 might be published in 2015.

Control0..1
TypeExtension(Artifact Effective Period) (Extension Type: Period)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Composition.extension:additionalLanguage
Slice NameadditionalLanguage
Definition

The Resource contains content in a language additional to the one in the language element.

ShortThe additional language
Control0..*
TypeExtension(Additional Language) (Extension Type: code)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Composition.extension:extendedContactDetail
Slice NameextendedContactDetail
Definition

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

ShortContact details for the publisher
Comments

May be a web site, an email address, a physical address, a telephone number, etc.

Control0..*
TypeExtension(Artifact Extended Contact Detail) (Extension Type: ExtendedContactDetail)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Composition.extension:publicationDate
Slice NamepublicationDate
Definition

Specifies the publication date of the Resource.

ShortPublication date of Resource
Control0..1
TypeExtension(Publication Date) (Extension Type: date)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Composition.extension:publicationStatus
Slice NamepublicationStatus
Definition

The status of the processing for making the artifact publicly available, not necessarily the same as artifact status (Resource.status).

ShortPublication status
Control0..1
TypeExtension(ArtifactPublicationStatus) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. Composition.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()))
SlicingThis element introduces a set of slices on Composition.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
44. Composition.url
Definition

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

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

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

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

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Composition.identifier
Definition

A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

ShortVersion-independent identifier for the Composition
Comments

Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Composition.version
Definition

An explicitly assigned identifier of a variation of the content in the Composition.

ShortAn explicitly assigned identifier of a variation of the content in the Composition
Comments

This element is the author-assigned business version of the Composition (analogous to CDA ClinicalDocument.versionNumber). It is distinct from Resource.meta.versionId, which is a server-assigned technical version that every resource carries and that may change whenever the resource is updated on a server. Composition.version reflects the version of a logical document's content and remains constant even if the Composition or its referenced resources are moved between servers and receive new meta.versionId values.

NoteThis is a business version Id, not a resource version Id (see discussion)
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Composition.consent
Definition

References the consents associated with this document. Examples include a consent to perform the clinical service being documented (.event) or a consent for the information contained in the document to be released to a third party.

ShortRepresents informed consents and medico-legal transactions
Control0..*
TypeReference(Consent)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. Composition.basedOn
Definition

A plan, proposal or order that is fulfilled in whole or in part by this composition.

ShortFulfills plan, proposal or order
Control0..*
TypeReference(Appointment, AppointmentResponse, CarePlan, Claim, CommunicationRequest, CoverageEligibilityRequest, DeviceRequest, MedicationRequest, NutritionOrder, RequestOrchestration, ServiceRequest, Task, VisionPrescription)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

Alternate Namesfulfills
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Composition.status
Definition

The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

Shortregistered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown
Comments

See section 2.8.3.2, The workflow/clinical status of the composition, for guidance. Because the entered-in-error flag changes how this resource and its related elements must be interpreted, status is labeled as a modifier element. Some reporting workflows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The Composition resource has no explicit status for noting whether this business rule is in effect; this would be handled by an extension if required.

Control1..1
BindingThe codes SHALL be taken from CompositionStatus
(required to http://hl7.org/fhir/ValueSet/composition-status|6.0.0-snapshot1)

The workflow status of the composition.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Requirements

Need to be able to mark interim, amended, or withdrawn compositions or documents.

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

Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

ShortKind of composition (LOINC if possible)
Comments

For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

Control1..1
BindingThe codes SHOULD be taken from FHIRDocumentTypeCodes
(preferred to http://hl7.org/fhir/ValueSet/doc-typecodes|6.0.0-snapshot1)

Type of a composition.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Key metadata element describing the composition, used in searching/filtering.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. Composition.type.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
60. Composition.type.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()))
SlicingThis element introduces a set of slices on Composition.type.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
62. Composition.type.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://loinc.org",
  "code" : "35528-9",
  "display" : "Clinical trial protocol Clinical trial protocol"
}
<coding>
  <system value="http://loinc.org"/>
  <code value="35528-9"/>
  <display value="Clinical trial protocol Clinical trial protocol"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. Composition.type.text
Definition

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

ShortPlain text representation of the concept
Comments

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

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

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

Pattern Value
{
  "text" : "CeSHarP Report"
}
<text value="CeSHarP Report"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. Composition.category
Definition

A categorization for the type of the composition - helps with indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

ShortCategorization of Composition
Control0..*
BindingFor example codes, see ReferencedItemCategoryValueSet
(example to http://hl7.org/fhir/ValueSet/referenced-item-category|6.0.0-snapshot1)

High-level kind of a clinical document at a macro level.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

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 Composition.category. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ text
68. Composition.category:intervention
Slice Nameintervention
Definition

A categorization for the type of the composition - helps with indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

ShortCategorization of Composition
Control0..1
BindingFor example codes, see ReferencedItemCategoryValueSet
(example to http://hl7.org/fhir/ValueSet/referenced-item-category|6.0.0-snapshot1)

High-level kind of a clinical document at a macro level.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. Composition.category:intervention.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
72. Composition.category:intervention.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()))
SlicingThis element introduces a set of slices on Composition.category.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
74. Composition.category:intervention.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218560",
  "display" : "ICH M11 Protocol Section 6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218560"/>
  <display value="ICH M11 Protocol Section 6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. Composition.category:intervention.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6-trial-intervention"
}
<text value="section6-trial-intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. Composition.subject
Definition

Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

ShortWho and/or what the composition is about
Comments

Reference a PublicationRecord Resource, ArtifactAssessment Resource (Classification Profile), Group Resource (EvidenceReportSubject Profile), ReserchStudy Resource, or any Resource to define a subject of this EvidenceReport.

Control0..*
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. Composition.encounter
Definition

Describes the clinical encounter or type of care this documentation is associated with.

ShortContext of the Composition
Control0..1
TypeReference(Encounter)
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Provides context for the composition and supports searching.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. Composition.date
Definition

The composition editing time, when the composition was last logically changed by the author.

ShortComposition editing time
Comments

The Last Modified Date on the composition may be after the date the document was attested without being changed. This means that the date on an amended document is the date of the amendment, not the date of original authorship.

Control1..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Requirements

dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring this version of the Composition. When packaged in a document, Bundle.timestamp is the date of packaging.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. Composition.useContext
Definition

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

ShortThe context that the content is intended to support
Comments

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

Control0..*
TypeUsageContext
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Assist in searching for appropriate content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. Composition.author
Definition

Identifies who is responsible for the information in the composition, not necessarily who typed it in.

ShortWho and/or what authored the composition
Comments

When the Composition is software-generated, a Device can be referenced. When a software-generated Composition is verified by a human (but not authored by that human), use the attester element to identify the human(s) who performed the verification.

Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. Composition.participant
Definition

Identifies supporting entities, including parents, relatives, caregivers, insurance policyholders, guarantors, and others related in some way to the patient. A supporting person or organization is an individual or an organization with a relationship to the patient. A supporting person who is playing multiple roles would be recorded in multiple participants (e.g., emergency contact and next-of-kin).

ShortIdentifies supporting entities, including parents, relatives, caregivers, insurance policyholders, guarantors, and others related in some way to the patient
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
90. Composition.participant.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
92. Composition.participant.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()))
SlicingThis element introduces a set of slices on Composition.participant.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
94. Composition.participant.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()))
SlicingThis element introduces a set of slices on Composition.participant.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
96. Composition.participant.type
Definition

Meaning and purpose of participation, in creation of the clinical document. The list includes: data entry person, informant, primary information recipient, and tracker. Other types are allowed.

ShortMeaning and purpose of participation, in creation of the clinical document
Control1..*
BindingThe codes SHOULD be taken from FHIR Clinical Document Participant Types Value set
(preferred to http://terminology.hl7.org/ValueSet/fhir-clinical-doc-participant)

FHIR Clinical Document Participant Types. Author, Authenticator, Custodian, Legal Authenticator, Record Target and Subject are found in distinct, named fields in FHIR. Thus, these types are excluded.

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

Exact function of the participant in the creation of the clinical document. This is more granular than type.

Control0..*
BindingThe codes SHOULD be taken from ParticipationFunction
(preferred to http://terminology.hl7.org/ValueSet/v3-ParticipationFunction)

To specify the exact function an actor had in a service in all necessary detail.

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

Time period of participation.

ShortTime period of participation
Control0..1
TypePeriod
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. Composition.participant.party
Definition

Who the participant is.

ShortWho the participant is
Control1..1
TypeReference(Practitioner, PractitionerRole, Patient, RelatedPerson, Device, Organization, CareTeam, Group)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. Composition.name
Definition

A machine-friendly identifier suitable for code generation. For example, 'ClinicalDocument' or 'Composition_v2'. See the Constraint description.

ShortComputer friendly name
Comments

The name is not expected to be globally unique. This field is used primarily by computers while the title field includes information for human-display. Composition.type is used to provide a CodeableConcept for the document type when available while Composition.name is an uncoded string. Composition.identifier is used to identify the specific instance of a document.

Control0..1
This element is affected by the following invariants: cmp-4
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Requirements

Support human navigation and code generation.

Invariantscmp-4: Name should start with an uppercase letter (A–Z), be 2 to 255 characters long, and contain only letters, digits, and underscores. Whitespace, hyphens, and other punctuation are not permitted (%resource.name.exists() implies %resource.name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$'))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. Composition.title
Definition

Official human-readable label for the composition.

ShortHuman Readable name/title
Comments

For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note").

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()))
108. Composition.note
Definition

For any additional notes.

ShortFor any additional notes
Comments

A comment, general note or annotation not coded elsewhere.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. Composition.classification
Definition

The assignment to an organizing scheme, including the type of classification and one or more classifier values.

ShortThe assignment to an organizing scheme
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
112. Composition.classification.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. Composition.classification.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()))
SlicingThis element introduces a set of slices on Composition.classification.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
116. Composition.classification.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()))
SlicingThis element introduces a set of slices on Composition.classification.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
118. Composition.classification.type
Definition

The kind of classifier (e.g. population, intervention, comparator, outcome).

ShortThe kind of classifier (e.g. population, intervention)
Control0..1
BindingFor example codes, see EvidenceClassifierTypeExample
(example to http://hl7.org/fhir/ValueSet/evidence-classifier-type-example|6.0.0-snapshot1)
TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. Composition.classification.classifier
Definition

The specific classification value.

ShortThe specific classification value
Control0..*
BindingFor example codes, see ConditionProblemDiagnosisCodes
(example to http://hl7.org/fhir/ValueSet/condition-code|6.0.0-snapshot1)
TypeCodeableReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
122. Composition.attester
Definition

A participant who has attested to the accuracy of the composition/document.

ShortAttests to accuracy of composition
Comments

Only list each attester once.

Control0..*
This element is affected by the following invariants: cmp-3
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies responsibility for the accuracy of the composition content.

Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
124. Composition.attester.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
126. Composition.attester.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()))
SlicingThis element introduces a set of slices on Composition.attester.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
128. Composition.attester.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()))
SlicingThis element introduces a set of slices on Composition.attester.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
130. Composition.attester.mode
Definition

The type of attestation the authenticator offers.

Shortreviewer | editor | endorser | informant | recorder
Control1..1
BindingThe codes SHOULD be taken from Contributor Role
(preferred to http://terminology.hl7.org/ValueSet/contributor-role)
TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Indicates the level of authority of the attestation.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
132. Composition.attester.time
Definition

When the composition was attested by the party.

ShortWhen the composition was attested
Control0..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Requirements

Identifies when the information in the composition was deemed accurate. (Things may have changed since then.)

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. Composition.attester.party
Definition

Who attested the composition in the specified way.

ShortWho attested the composition
Control0..1
TypeReference(Patient, RelatedPerson, Practitioner, PractitionerRole, Organization, Group)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who has taken on the responsibility for accuracy of the composition content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
136. Composition.custodian
Definition

Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

ShortOrganization which maintains the composition
Comments

This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

Control0..1
TypeReference(Organization, Patient, Group)
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Identifies where to go to find the current version, where to report issues, etc.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
138. Composition.relatesTo
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.relatesTo. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ type

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

140. Composition.relatesTo.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. Composition.relatesTo.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
144. Composition.relatesTo.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. Composition.relatesTo.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
148. Composition.relatesTo.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
150. Composition.relatesTo.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
152. Composition.relatesTo:citeAs
Slice NameciteAs
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..1
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
154. Composition.relatesTo:citeAs.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
156. Composition.relatesTo:citeAs.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
158. Composition.relatesTo:citeAs.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
160. Composition.relatesTo:citeAs.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
162. Composition.relatesTo:citeAs.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "cite-as"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="cite-as"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
164. Composition.relatesTo:citeAs.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
166. Composition.relatesTo:partOf
Slice NamepartOf
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
168. Composition.relatesTo:partOf.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. Composition.relatesTo:partOf.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
172. Composition.relatesTo:partOf.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
174. Composition.relatesTo:partOf.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
176. Composition.relatesTo:partOf.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "part-of"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="part-of"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
178. Composition.relatesTo:partOf.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
180. Composition.relatesTo:derivedFrom
Slice NamederivedFrom
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
182. Composition.relatesTo:derivedFrom.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
184. Composition.relatesTo:derivedFrom.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
186. Composition.relatesTo:derivedFrom.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
188. Composition.relatesTo:derivedFrom.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
190. Composition.relatesTo:derivedFrom.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "derived-from"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="derived-from"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
192. Composition.relatesTo:derivedFrom.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
194. Composition.relatesTo:specificationOf
Slice NamespecificationOf
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
196. Composition.relatesTo:specificationOf.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. Composition.relatesTo:specificationOf.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
200. Composition.relatesTo:specificationOf.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
202. Composition.relatesTo:specificationOf.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
204. Composition.relatesTo:specificationOf.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "specification-of"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="specification-of"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
206. Composition.relatesTo:specificationOf.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
208. Composition.relatesTo:dependsOn
Slice NamedependsOn
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
210. Composition.relatesTo:dependsOn.id
Definition

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

ShortUnique id for inter-element referencing
Control0..1
This element is affected by the following invariants: ele-1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
212. Composition.relatesTo:dependsOn.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
214. Composition.relatesTo:dependsOn.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
216. Composition.relatesTo:dependsOn.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
218. Composition.relatesTo:dependsOn.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "depends-on"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="depends-on"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
220. Composition.relatesTo:dependsOn.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
222. Composition.relatesTo:supportedWith
Slice NamesupportedWith
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
224. Composition.relatesTo:supportedWith.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. Composition.relatesTo:supportedWith.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
228. Composition.relatesTo:supportedWith.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
230. Composition.relatesTo:supportedWith.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
232. Composition.relatesTo:supportedWith.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "supported-with"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="supported-with"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
234. Composition.relatesTo:supportedWith.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
236. Composition.relatesTo:similarTo
Slice NamesimilarTo
Definition

Relationships that this composition has with other compositions or documents (FHIR or non-FHIR resources) that already exist.

ShortRelationships to other compositions/documents
Comments

To reference (using relatesTo) a Bundle of type "document" or another Composition where you only have the identifier, use a targetReference with an identifier.
When a Composition is an alternate representation of another type of document e.g. CDA, the other document could be referenced in a DocumentReference resource.
Here is an example of using relatesTo to reference another Bundle of type "document" or Composition where you only have the identifier:

"relatesTo": [{
  "type": "replaces",
  "targetReference": {
    "identifier": { 
      "system": "...", 
      "value": "..."
    }
  } 
}]
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
238. Composition.relatesTo:similarTo.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
240. Composition.relatesTo:similarTo.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
242. Composition.relatesTo:similarTo.extension:classifier
Slice Nameclassifier
Definition

A classifier of the target artifact in a relatesTo element.

ShortA classifier of the target artifact in a relatesTo element
Control0..1
TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
244. Composition.relatesTo:similarTo.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()))
SlicingThis element introduces a set of slices on Composition.relatesTo.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
246. Composition.relatesTo:similarTo.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 | reprint | reprint-of | summarizes
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Artifact Relationship Type
(extensible to http://terminology.hl7.org/ValueSet/artifact-relationship-type)

The type of relationship to the related artifact.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/artifact-relationship-type",
      "code" : "similar-to"
    }
  ]
}
<type>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/artifact-relationship-type"/>
    <code value="similar-to"/>
  </coding>
</type>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
248. Composition.relatesTo:similarTo.target[x]
Definition

The artifact that is related to this Composition Resource.

ShortThe artifact that is related to this Composition
Control1..1
TypeChoice of: uri, Attachment, canonical(Resource), Reference(Resource), 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()))
250. Composition.event
Definition

The clinical service, such as a colonoscopy or an appendectomy, being documented.

ShortThe clinical service(s) being documented
Comments

The event needs to be consistent with the type element, though it can provide further information if desired.

Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
252. Composition.event.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. Composition.event.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()))
SlicingThis element introduces a set of slices on Composition.event.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
256. Composition.event.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()))
SlicingThis element introduces a set of slices on Composition.event.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
258. Composition.event.period
Definition

The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

ShortThe period covered by the documentation
Control0..1
TypePeriod
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
260. Composition.event.detail
Definition

Represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which case the procedure being documented is necessarily a "History and Physical" act. The events may be included as a code or as a reference to another resource.

ShortThe event(s) being documented, as code(s), reference(s), or both
Comments

An event can further specialize the act inherent in Composition.type, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more events are included, they SHALL NOT conflict with the values inherent in Composition.type as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

Control0..*
BindingFor example codes, see v3 Code System ActCode
(example to http://terminology.hl7.org/ValueSet/v3-ActCode)

This list of codes represents the main clinical acts being documented.

TypeCodeableReference(Resource)
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
262. Composition.section
Definition

The root of the sections that make up the composition.

ShortComposition is broken into sections
Control1..1
This element is affected by the following invariants: cmp-3
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if no entries are included (emptyReason.empty() or entry.empty())
cmp-3: If attester exists then the Composition either needs a text or a section (%resource.attester.exists() implies(text.exists() or section.exists()))
ele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

264. Composition.section.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
266. Composition.section.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()))
SlicingThis element introduces a set of slices on Composition.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
268. Composition.section.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()))
SlicingThis element introduces a set of slices on Composition.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
270. Composition.section.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
272. Composition.section.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
(extensible to https://fevir.net/resources/ValueSet/179431)
TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
274. Composition.section.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
276. Composition.section.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
278. Composition.section.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
280. Composition.section.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
282. Composition.section.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
284. Composition.section.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
286. Composition.section.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
288. Composition.section.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
290. Composition.section:intervention
Slice Nameintervention
Definition

The root of the sections that make up the composition.

ShortComposition is broken into sections
Control1..1
This element is affected by the following invariants: cmp-3
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if no entries are included (emptyReason.empty() or entry.empty())
cmp-3: If attester exists then the Composition either needs a text or a section (%resource.attester.exists() implies(text.exists() or section.exists()))
ele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
292. Composition.section:intervention.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
294. Composition.section:intervention.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()))
SlicingThis element introduces a set of slices on Composition.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
296. Composition.section:intervention.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()))
SlicingThis element introduces a set of slices on Composition.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
298. Composition.section:intervention.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"
}
<title value="6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
300. Composition.section:intervention.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
(extensible to https://fevir.net/resources/ValueSet/179431)
TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
302. Composition.section:intervention.code.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
304. Composition.section:intervention.code.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()))
SlicingThis element introduces a set of slices on Composition.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
306. Composition.section:intervention.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218560",
  "display" : "ICH M11 Protocol Section 6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218560"/>
  <display value="ICH M11 Protocol Section 6 TRIAL INTERVENTION AND CONCOMITANT THERAPY"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
308. Composition.section:intervention.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6-trial-intervention"
}
<text value="section6-trial-intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
310. Composition.section:intervention.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
312. Composition.section:intervention.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
314. Composition.section:intervention.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Trial interventions are all pre-specified investigational and noninvestigational medicinal products, medical devices or other interventions intended for the participants during the trial. The investigational trial intervention is the product used in the trial as part of trial objectives. Description of the investigational trial intervention is provided in Section 6.1 Description of Trial Intervention. Other trial interventions that are not part of trial objectives or do not have an investigational role in this trial are described in Section 6.9 Description of Noninvestigational Trial Interventions. Any regional requirements should be noted in the appropriate subsections. Provide an overview of investigational and noninvestigational trial interventions. Classify the trial intervention as IMP, NIMP/AxMP designations based on trial design and regional requirements. Consider an optional table with 12 columns (Arm Name, Arm Type, Intervention Name, Intervention Type, Pharmaceutical Dose Form, Dosage Strength(s), Dosage Level(s), Route of Administration, Regimen/Treatment Period/Vaccination Regimen, Use, IMP/NIMP, Sourcing).

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
316. Composition.section:intervention.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
318. Composition.section:intervention.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
320. Composition.section:intervention.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
322. Composition.section:intervention.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
324. Composition.section:intervention.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control10..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
326. Composition.section:intervention.section.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
328. Composition.section:intervention.section.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()))
SlicingThis element introduces a set of slices on Composition.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
330. Composition.section:intervention.section.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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
332. Composition.section:intervention.section.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
334. Composition.section:intervention.section.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from EvidenceReportSectionCode Value Set
(extensible to https://fevir.net/resources/ValueSet/179431)
TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
336. Composition.section:intervention.section.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
338. Composition.section:intervention.section.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
340. Composition.section:intervention.section.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
342. Composition.section:intervention.section.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
344. Composition.section:intervention.section.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
346. Composition.section:intervention.section.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
348. Composition.section:intervention.section.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
350. Composition.section:intervention.section.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
352. Composition.section:intervention.section:description
Slice Namedescription
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
354. Composition.section:intervention.section:description.id
Definition

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

ShortUnique id for inter-element referencing
Control0..1
This element is affected by the following invariants: ele-1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
356. Composition.section:intervention.section:description.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()))
SlicingThis element introduces a set of slices on Composition.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
358. Composition.section:intervention.section:description.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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
360. Composition.section:intervention.section:description.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.1 Description of Investigational Trial Intervention"
}
<title value="6.1 Description of Investigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
362. Composition.section:intervention.section:description.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
364. Composition.section:intervention.section:description.code.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
366. Composition.section:intervention.section:description.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
368. Composition.section:intervention.section:description.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218561",
  "display" : "ICH M11 Protocol Section 6.1 Description of Investigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218561"/>
  <display value="ICH M11 Protocol Section 6.1 Description of Investigational Trial Intervention"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
370. Composition.section:intervention.section:description.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.1-description-of-trial-intervention"
}
<text value="section6.1-description-of-trial-intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
372. Composition.section:intervention.section:description.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
374. Composition.section:intervention.section:description.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
376. Composition.section:intervention.section:description.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe the investigational trial intervention to be administered in each arm of the trial and for each period of the trial including route and mode of administration, dose, dosage regimen, duration of intervention, use, packaging and labelling. Refer to approved regional labelling, as appropriate. For investigational drug/device combination products, include details on the configuration and use of the device and device manufacturer. A device user manual may be referenced in this section. Entries should Reference ConceptualExposureDefinition Profile of Group Resource.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
378. Composition.section:intervention.section:description.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
380. Composition.section:intervention.section:description.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
382. Composition.section:intervention.section:description.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(ConceptualExposureDefinition)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
384. Composition.section:intervention.section:description.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
386. Composition.section:intervention.section:description.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
388. Composition.section:intervention.section:rationale
Slice Namerationale
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
390. Composition.section:intervention.section:rationale.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
392. Composition.section:intervention.section:rationale.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()))
SlicingThis element introduces a set of slices on Composition.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
394. Composition.section:intervention.section:rationale.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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
396. Composition.section:intervention.section:rationale.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.2 Rationale for Investigational Trial Intervention Dose and Regimen"
}
<title value="6.2 Rationale for Investigational Trial Intervention Dose and Regimen"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
398. Composition.section:intervention.section:rationale.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
400. Composition.section:intervention.section:rationale.code.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
402. Composition.section:intervention.section:rationale.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
404. Composition.section:intervention.section:rationale.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218562",
  "display" : "ICH M11 Protocol Section 6.2 Rationale for Investigational Trial Intervention Dose and Regimen"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218562"/>
  <display value="ICH M11 Protocol Section 6.2 Rationale for Investigational Trial Intervention Dose and Regimen"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
406. Composition.section:intervention.section:rationale.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.2-rationale-for-trial-intervention-regimen"
}
<text value="section6.2-rationale-for-trial-intervention-regimen"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
408. Composition.section:intervention.section:rationale.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
410. Composition.section:intervention.section:rationale.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
412. Composition.section:intervention.section:rationale.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Provide a rationale for the selection of the dose(s) or dose range, pharmaceutical dose form, route of administration, and dosing regimen of the investigational trial intervention, as applicable. This rationale should include relevant results from nonclinical studies and clinical trials that support selection of the dose and regimen. Discuss impact of differences in trial population characteristics (e.g., age, sex, race) which could lead to differences in pharmacokinetics and pharmacodynamics in this trial as compared to previous trials. If applicable, justify any differences in dose regimen or therapeutic use relative to approved labelling. Describe prior trials and other information that support the dose and/or dose regimen of the investigational trial intervention. Include a rationale for prospective dose adjustments incorporated in the trial, if any. Entries should Reference ConceptualExposureDefinition Profile of Group Resource.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
414. Composition.section:intervention.section:rationale.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
416. Composition.section:intervention.section:rationale.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
418. Composition.section:intervention.section:rationale.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(ConceptualExposureDefinition)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
420. Composition.section:intervention.section:rationale.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
422. Composition.section:intervention.section:rationale.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
424. Composition.section:intervention.section:dosingAdministration
Slice NamedosingAdministration
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
426. Composition.section:intervention.section:dosingAdministration.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
428. Composition.section:intervention.section:dosingAdministration.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()))
SlicingThis element introduces a set of slices on Composition.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
430. Composition.section:intervention.section:dosingAdministration.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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
432. Composition.section:intervention.section:dosingAdministration.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.3 Investigational Trial Intervention Administration"
}
<title value="6.3 Investigational Trial Intervention Administration"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
434. Composition.section:intervention.section:dosingAdministration.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
436. Composition.section:intervention.section:dosingAdministration.code.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
438. Composition.section:intervention.section:dosingAdministration.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
440. Composition.section:intervention.section:dosingAdministration.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218563",
  "display" : "ICH M11 Protocol Section 6.3 Investigational Trial Intervention Administration"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218563"/>
  <display value="ICH M11 Protocol Section 6.3 Investigational Trial Intervention Administration"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
442. Composition.section:intervention.section:dosingAdministration.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.3-dosing-and-administration"
}
<text value="section6.3-dosing-and-administration"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
444. Composition.section:intervention.section:dosingAdministration.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
446. Composition.section:intervention.section:dosingAdministration.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
448. Composition.section:intervention.section:dosingAdministration.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe the detailed procedures for administration of each participant’s dose of each investigational trial intervention. This may include the timing of dosing (e.g., time of day, interval), the duration (e.g., the length of time participants will be administered the investigational trial intervention), and the timing of dosing relative to meals. Include any specific instructions on who, when or how to prepare and take the dose(s) and how to handle any delayed or missed doses. Dose escalation or cohort expansion as part of the overall design should be covered in Section 4.1 Description of Trial Design. Entries should Reference ActivityDefinition Resource.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
450. Composition.section:intervention.section:dosingAdministration.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
452. Composition.section:intervention.section:dosingAdministration.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
454. Composition.section:intervention.section:dosingAdministration.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(ActivityDefinition)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
456. Composition.section:intervention.section:dosingAdministration.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
458. Composition.section:intervention.section:dosingAdministration.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
460. Composition.section:intervention.section:doseModification
Slice NamedoseModification
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
462. Composition.section:intervention.section:doseModification.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
464. Composition.section:intervention.section:doseModification.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()))
SlicingThis element introduces a set of slices on Composition.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
466. Composition.section:intervention.section:doseModification.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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
468. Composition.section:intervention.section:doseModification.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.4 Investigational Trial Intervention Dose Modification"
}
<title value="6.4 Investigational Trial Intervention Dose Modification"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
470. Composition.section:intervention.section:doseModification.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
472. Composition.section:intervention.section:doseModification.code.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
474. Composition.section:intervention.section:doseModification.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
476. Composition.section:intervention.section:doseModification.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218564",
  "display" : "ICH M11 Protocol Section 6.4 Investigational Trial Intervention Dose Modification"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218564"/>
  <display value="ICH M11 Protocol Section 6.4 Investigational Trial Intervention Dose Modification"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
478. Composition.section:intervention.section:doseModification.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.4-dose-modification"
}
<text value="section6.4-dose-modification"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
480. Composition.section:intervention.section:doseModification.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
482. Composition.section:intervention.section:doseModification.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
484. Composition.section:intervention.section:doseModification.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

For each participant, describe any dose modifications allowed, including conditions for such dose modifications, particularly regarding failure to respond or safety concerns. State any minimum period required before a participant’s dose might be raised to the next higher dose or dose range. Include whether it is permissible to start and stop treatment and how dose reductions (if permitted) are to be managed. Information on stopping investigational trial intervention for participants due to safety/other reasons should be described in Section 7 Participant Discontinuation of Trial Intervention and Discontinuation or Withdrawal from Trial. Entries should Reference ActivityDefinition Resource.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
486. Composition.section:intervention.section:doseModification.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
488. Composition.section:intervention.section:doseModification.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
490. Composition.section:intervention.section:doseModification.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(ActivityDefinition)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
492. Composition.section:intervention.section:doseModification.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
494. Composition.section:intervention.section:doseModification.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
496. Composition.section:intervention.section:treatmentOfOverdose
Slice NametreatmentOfOverdose
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
498. Composition.section:intervention.section:treatmentOfOverdose.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
500. Composition.section:intervention.section:treatmentOfOverdose.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()))
SlicingThis element introduces a set of slices on Composition.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
502. Composition.section:intervention.section:treatmentOfOverdose.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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
504. Composition.section:intervention.section:treatmentOfOverdose.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.5 Management of Investigational Trial Intervention Overdose"
}
<title value="6.5 Management of Investigational Trial Intervention Overdose"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
506. Composition.section:intervention.section:treatmentOfOverdose.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
508. Composition.section:intervention.section:treatmentOfOverdose.code.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
510. Composition.section:intervention.section:treatmentOfOverdose.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
512. Composition.section:intervention.section:treatmentOfOverdose.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218565",
  "display" : "ICH M11 Protocol Section 6.5 Management of Investigational Trial Intervention Overdose"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218565"/>
  <display value="ICH M11 Protocol Section 6.5 Management of Investigational Trial Intervention Overdose"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
514. Composition.section:intervention.section:treatmentOfOverdose.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.5-management-of-overdose"
}
<text value="section6.5-management-of-overdose"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
516. Composition.section:intervention.section:treatmentOfOverdose.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
518. Composition.section:intervention.section:treatmentOfOverdose.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
520. Composition.section:intervention.section:treatmentOfOverdose.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe what is meant by investigational trial intervention overdose. Provide any available information on managing the overdose and ensure it is consistent with the Investigator’s Brochure or product labelling. Cross reference these documents as applicable. Entries should Reference ActivityDefinition Resource or PlanDefinition Resource.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
522. Composition.section:intervention.section:treatmentOfOverdose.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
524. Composition.section:intervention.section:treatmentOfOverdose.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
526. Composition.section:intervention.section:treatmentOfOverdose.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(ActivityDefinition, PlanDefinition)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
528. Composition.section:intervention.section:treatmentOfOverdose.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
530. Composition.section:intervention.section:treatmentOfOverdose.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
532. Composition.section:intervention.section:preparation
Slice Namepreparation
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
534. Composition.section:intervention.section:preparation.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
536. Composition.section:intervention.section:preparation.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()))
SlicingThis element introduces a set of slices on Composition.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
538. Composition.section:intervention.section:preparation.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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
540. Composition.section:intervention.section:preparation.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.6 Preparation, Storage, Handling and Accountability of Investigational Trial Intervention"
}
<title value="6.6 Preparation, Storage, Handling and Accountability of Investigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
542. Composition.section:intervention.section:preparation.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
544. Composition.section:intervention.section:preparation.code.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
546. Composition.section:intervention.section:preparation.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
548. Composition.section:intervention.section:preparation.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218566",
  "display" : "ICH M11 Protocol Section 6.6 Preparation, Storage, Handling and Accountability of Investigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218566"/>
  <display value="ICH M11 Protocol Section 6.6 Preparation, Storage, Handling and Accountability of Investigational Trial Intervention"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
550. Composition.section:intervention.section:preparation.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.6-preparation-storage-handling"
}
<text value="section6.6-preparation-storage-handling"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
552. Composition.section:intervention.section:preparation.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
554. Composition.section:intervention.section:preparation.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
556. Composition.section:intervention.section:preparation.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

No text is intended here (heading only).

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
558. Composition.section:intervention.section:preparation.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
560. Composition.section:intervention.section:preparation.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
562. Composition.section:intervention.section:preparation.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
564. Composition.section:intervention.section:preparation.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
566. Composition.section:intervention.section:preparation.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control3..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.section.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
568. Composition.section:intervention.section:preparation.section.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
570. Composition.section:intervention.section:preparation.section.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
572. Composition.section:intervention.section:preparation.section.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
574. Composition.section:intervention.section:preparation.section.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
576. Composition.section:intervention.section:preparation.section.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
578. Composition.section:intervention.section:preparation.section.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
580. Composition.section:intervention.section:preparation.section.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
582. Composition.section:intervention.section:preparation.section.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
584. Composition.section:intervention.section:preparation.section.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
586. Composition.section:intervention.section:preparation.section.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
588. Composition.section:intervention.section:preparation.section.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
590. Composition.section:intervention.section:preparation.section.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
592. Composition.section:intervention.section:preparation.section.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
594. Composition.section:intervention.section:preparation.section:preparationIntervention
Slice NamepreparationIntervention
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
596. Composition.section:intervention.section:preparation.section:preparationIntervention.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
598. Composition.section:intervention.section:preparation.section:preparationIntervention.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
600. Composition.section:intervention.section:preparation.section:preparationIntervention.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
602. Composition.section:intervention.section:preparation.section:preparationIntervention.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.6.1 Preparation of Investigational Trial Intervention"
}
<title value="6.6.1 Preparation of Investigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
604. Composition.section:intervention.section:preparation.section:preparationIntervention.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
606. Composition.section:intervention.section:preparation.section:preparationIntervention.code.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
608. Composition.section:intervention.section:preparation.section:preparationIntervention.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
610. Composition.section:intervention.section:preparation.section:preparationIntervention.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218567",
  "display" : "ICH M11 Protocol Section 6.6.1 Preparation of Investigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218567"/>
  <display value="ICH M11 Protocol Section 6.6.1 Preparation of Investigational Trial Intervention"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
612. Composition.section:intervention.section:preparation.section:preparationIntervention.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.6.1-preparation"
}
<text value="section6.6.1-preparation"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
614. Composition.section:intervention.section:preparation.section:preparationIntervention.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
616. Composition.section:intervention.section:preparation.section:preparationIntervention.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
618. Composition.section:intervention.section:preparation.section:preparationIntervention.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe any preparation of the investigational trial intervention, and when necessary, who should prepare it. When applicable, describe the maximum hold time once thawed/mixed before administration. Include thawing, diluting, mixing, and reconstitution/preparation instructions. For drug/device combination products, include any relevant assembly or use instructions and reference the package insert that is provided separately. If the instructions are lengthy or complicated, it is acceptable to reference the package insert (if applicable) or include instructions in separate documents provided to the site (e.g., a pharmacy manual and reference the separate documents.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
620. Composition.section:intervention.section:preparation.section:preparationIntervention.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
622. Composition.section:intervention.section:preparation.section:preparationIntervention.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
624. Composition.section:intervention.section:preparation.section:preparationIntervention.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
626. Composition.section:intervention.section:preparation.section:preparationIntervention.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
628. Composition.section:intervention.section:preparation.section:preparationIntervention.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
630. Composition.section:intervention.section:preparation.section:storageHandling
Slice NamestorageHandling
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
632. Composition.section:intervention.section:preparation.section:storageHandling.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
634. Composition.section:intervention.section:preparation.section:storageHandling.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
636. Composition.section:intervention.section:preparation.section:storageHandling.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
638. Composition.section:intervention.section:preparation.section:storageHandling.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.6.2 Storage and Handling of Investigational Trial Intervention"
}
<title value="6.6.2 Storage and Handling of Investigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
640. Composition.section:intervention.section:preparation.section:storageHandling.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
642. Composition.section:intervention.section:preparation.section:storageHandling.code.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
644. Composition.section:intervention.section:preparation.section:storageHandling.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
646. Composition.section:intervention.section:preparation.section:storageHandling.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218568",
  "display" : "ICH M11 Protocol Section 6.6.2 Storage and Handling of Investigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218568"/>
  <display value="ICH M11 Protocol Section 6.6.2 Storage and Handling of Investigational Trial Intervention"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
648. Composition.section:intervention.section:preparation.section:storageHandling.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.6.2-storage-handling"
}
<text value="section6.6.2-storage-handling"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
650. Composition.section:intervention.section:preparation.section:storageHandling.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
652. Composition.section:intervention.section:preparation.section:storageHandling.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
654. Composition.section:intervention.section:preparation.section:storageHandling.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe storage and handling requirements (e.g., protection from light, temperature, humidity) for the investigational trial intervention(s). For trials in which multi-dose vials are utilised, provide additional information regarding stability and expiration time after initial use (e.g., if the seal is broken). Explain how the investigational trial intervention will be provided to the Investigator. If applicable, include details about kits, packaging, or other material of the investigational trial intervention for blinding purposes. If the instructions are lengthy or complicated, it is acceptable to reference the package insert (if applicable) or include instructions in separate documents provided to the site (e.g., a pharmacy manual) and reference the separate documents.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
656. Composition.section:intervention.section:preparation.section:storageHandling.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
658. Composition.section:intervention.section:preparation.section:storageHandling.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
660. Composition.section:intervention.section:preparation.section:storageHandling.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
662. Composition.section:intervention.section:preparation.section:storageHandling.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
664. Composition.section:intervention.section:preparation.section:storageHandling.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
666. Composition.section:intervention.section:preparation.section:accountability
Slice Nameaccountability
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
668. Composition.section:intervention.section:preparation.section:accountability.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
670. Composition.section:intervention.section:preparation.section:accountability.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
672. Composition.section:intervention.section:preparation.section:accountability.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
674. Composition.section:intervention.section:preparation.section:accountability.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.6.3 Accountability of Investigational Trial Intervention"
}
<title value="6.6.3 Accountability of Investigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
676. Composition.section:intervention.section:preparation.section:accountability.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
678. Composition.section:intervention.section:preparation.section:accountability.code.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
680. Composition.section:intervention.section:preparation.section:accountability.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
682. Composition.section:intervention.section:preparation.section:accountability.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218569",
  "display" : "ICH M11 Protocol Section 6.6.3 Accountability of Investigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218569"/>
  <display value="ICH M11 Protocol Section 6.6.3 Accountability of Investigational Trial Intervention"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
684. Composition.section:intervention.section:preparation.section:accountability.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.6.3-accountability"
}
<text value="section6.6.3-accountability"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
686. Composition.section:intervention.section:preparation.section:accountability.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
688. Composition.section:intervention.section:preparation.section:accountability.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
690. Composition.section:intervention.section:preparation.section:accountability.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe the accountability method, including: • how the investigational trial intervention will be distributed • who will distribute the investigational trial intervention • participation of a drug storage repository or pharmacy, if applicable • plans for disposal or return of unused product • if applicable, plans for reconciliation of investigational trial intervention

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
692. Composition.section:intervention.section:preparation.section:accountability.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
694. Composition.section:intervention.section:preparation.section:accountability.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
696. Composition.section:intervention.section:preparation.section:accountability.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
698. Composition.section:intervention.section:preparation.section:accountability.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
700. Composition.section:intervention.section:preparation.section:accountability.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
702. Composition.section:intervention.section:assignmentAndBlinding
Slice NameassignmentAndBlinding
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
704. Composition.section:intervention.section:assignmentAndBlinding.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
706. Composition.section:intervention.section:assignmentAndBlinding.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()))
SlicingThis element introduces a set of slices on Composition.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
708. Composition.section:intervention.section:assignmentAndBlinding.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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
710. Composition.section:intervention.section:assignmentAndBlinding.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.7 Investigational Trial Intervention Assignment, Randomisation and Blinding"
}
<title value="6.7 Investigational Trial Intervention Assignment, Randomisation and Blinding"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
712. Composition.section:intervention.section:assignmentAndBlinding.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
714. Composition.section:intervention.section:assignmentAndBlinding.code.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
716. Composition.section:intervention.section:assignmentAndBlinding.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
718. Composition.section:intervention.section:assignmentAndBlinding.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218570",
  "display" : "ICH M11 Protocol Section 6.7 Investigational Trial Intervention Assignment, Randomisation and Blinding"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218570"/>
  <display value="ICH M11 Protocol Section 6.7 Investigational Trial Intervention Assignment, Randomisation and Blinding"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
720. Composition.section:intervention.section:assignmentAndBlinding.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.7-assignment-randomisation-blinding"
}
<text value="section6.7-assignment-randomisation-blinding"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
722. Composition.section:intervention.section:assignmentAndBlinding.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
724. Composition.section:intervention.section:assignmentAndBlinding.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
726. Composition.section:intervention.section:assignmentAndBlinding.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

No text is intended here (heading only).

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
728. Composition.section:intervention.section:assignmentAndBlinding.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
730. Composition.section:intervention.section:assignmentAndBlinding.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
732. Composition.section:intervention.section:assignmentAndBlinding.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
734. Composition.section:intervention.section:assignmentAndBlinding.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
736. Composition.section:intervention.section:assignmentAndBlinding.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control4..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.section.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
738. Composition.section:intervention.section:assignmentAndBlinding.section.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
740. Composition.section:intervention.section:assignmentAndBlinding.section.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
742. Composition.section:intervention.section:assignmentAndBlinding.section.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
744. Composition.section:intervention.section:assignmentAndBlinding.section.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
746. Composition.section:intervention.section:assignmentAndBlinding.section.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
748. Composition.section:intervention.section:assignmentAndBlinding.section.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
750. Composition.section:intervention.section:assignmentAndBlinding.section.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
752. Composition.section:intervention.section:assignmentAndBlinding.section.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
754. Composition.section:intervention.section:assignmentAndBlinding.section.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
756. Composition.section:intervention.section:assignmentAndBlinding.section.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
758. Composition.section:intervention.section:assignmentAndBlinding.section.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
760. Composition.section:intervention.section:assignmentAndBlinding.section.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
762. Composition.section:intervention.section:assignmentAndBlinding.section.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
764. Composition.section:intervention.section:assignmentAndBlinding.section:assignment
Slice Nameassignment
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
766. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.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
768. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
770. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
772. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.7.1 Participant Assignment to Investigational Trial Intervention"
}
<title value="6.7.1 Participant Assignment to Investigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
774. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
776. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.code.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
778. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
780. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218571",
  "display" : "ICH M11 Protocol Section 6.7.1 Participant Assignment to Investigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218571"/>
  <display value="ICH M11 Protocol Section 6.7.1 Participant Assignment to Investigational Trial Intervention"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
782. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.7.1-assignment"
}
<text value="section6.7.1-assignment"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
784. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
786. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
788. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

State that at enrollment, participant identification codes should be assigned. Describe the method of assigning participants to investigational trial intervention without being so specific that blinding or randomisation might be compromised. If assignment to investigational trial intervention is by randomisation, describe when randomisation occurs relative to screening. If adaptive randomisation or other methods of covariate balancing/minimisation are employed, include a cross reference to the methods of analysis in Section 10 Statistical Considerations. As applicable, details regarding the implementation of procedures to minimise bias should be described.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
790. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
792. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
794. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
796. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
798. Composition.section:intervention.section:assignmentAndBlinding.section:assignment.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
800. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation
Slice Namerandomisation
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
802. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.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
804. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
806. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
808. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.7.2 Randomisation"
}
<title value="6.7.2 Randomisation"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
810. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
812. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.code.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
814. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
816. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218572",
  "display" : "ICH M11 Protocol Section 6.7.2 Randomisation"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218572"/>
  <display value="ICH M11 Protocol Section 6.7.2 Randomisation"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
818. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.7.2-randomisation"
}
<text value="section6.7.2-randomisation"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
820. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
822. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
824. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe the randomisation procedures (e.g., central randomisation procedures), the method used to generate the randomisation schedule (e.g., computer generated), the source of the randomisation schedule (e.g., sponsor, investigator, or other), and whether IxRS will be used. To maintain the integrity of the blinding, do not include the block size.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
826. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
828. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
830. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
832. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
834. Composition.section:intervention.section:assignmentAndBlinding.section:randomisation.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
836. Composition.section:intervention.section:assignmentAndBlinding.section:blinding
Slice Nameblinding
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
838. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.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
840. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
842. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
844. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.7.3 Measures to Maintain Blinding"
}
<title value="6.7.3 Measures to Maintain Blinding"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
846. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
848. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.code.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
850. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
852. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218573",
  "display" : "ICH M11 Protocol Section 6.7.3 Measures to Maintain Blinding"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218573"/>
  <display value="ICH M11 Protocol Section 6.7.3 Measures to Maintain Blinding"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
854. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.7.3-blinding"
}
<text value="section6.7.3-blinding"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
856. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
858. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
860. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe measures that will be used to maintain blinding: • The investigational trial interventions are as indistinguishable as possible • Plans for the maintenance of randomisation codes and appropriate blinding for the trial • Procedures for planned (e.g., interim analysis) and unintentional (e.g., breach of procedure) breaking of randomisation codes. For unplanned but intentional actions (e.g., safety events), refer to Section 6.7.4 Emergency Unblinding at the Site. If the trial allows for some investigators or other designated staff to remain unblinded (e.g., to allow them to adjust investigational trial intervention), the means of maintaining the blinding for other investigators or staff should be explained. Measures to prevent unblinding by laboratory measurements or while performing study assessments, if used, should be described.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
862. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
864. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
866. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
868. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
870. Composition.section:intervention.section:assignmentAndBlinding.section:blinding.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
872. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding
Slice Nameunblinding
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
874. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.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
876. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
878. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
880. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.7.4 Emergency Unblinding at the Site"
}
<title value="6.7.4 Emergency Unblinding at the Site"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
882. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
884. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.code.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
886. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
888. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218574",
  "display" : "ICH M11 Protocol Section 6.7.4 Emergency Unblinding at the Site"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218574"/>
  <display value="ICH M11 Protocol Section 6.7.4 Emergency Unblinding at the Site"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
890. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.7.4-unblinding"
}
<text value="section6.7.4-unblinding"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
892. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
894. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
896. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe the criteria for breaking the trial blind or participant code. Describe the circumstances in which the blinding would be broken for an individual or for all participants and who has responsibility. Include the procedure for emergency unblinding such as via IxRS or code envelopes as well as documentation of unblinding. Indicate to whom the intentional and unintentional unblinding should be reported.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
898. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
900. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
902. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
904. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
906. Composition.section:intervention.section:assignmentAndBlinding.section:unblinding.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
908. Composition.section:intervention.section:adherence
Slice Nameadherence
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
910. Composition.section:intervention.section:adherence.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
912. Composition.section:intervention.section:adherence.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()))
SlicingThis element introduces a set of slices on Composition.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
914. Composition.section:intervention.section:adherence.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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
916. Composition.section:intervention.section:adherence.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.8 Investigational Trial Intervention Adherence"
}
<title value="6.8 Investigational Trial Intervention Adherence"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
918. Composition.section:intervention.section:adherence.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
920. Composition.section:intervention.section:adherence.code.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
922. Composition.section:intervention.section:adherence.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
924. Composition.section:intervention.section:adherence.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218575",
  "display" : "ICH M11 Protocol Section 6.8 Investigational Trial Intervention Adherence"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218575"/>
  <display value="ICH M11 Protocol Section 6.8 Investigational Trial Intervention Adherence"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
926. Composition.section:intervention.section:adherence.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.8-intervention-adherence"
}
<text value="section6.8-intervention-adherence"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
928. Composition.section:intervention.section:adherence.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
930. Composition.section:intervention.section:adherence.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
932. Composition.section:intervention.section:adherence.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe the measures to monitor and document participants’ adherence with investigational trial intervention (e.g., trial intervention accountability records, diary cards, or investigational trial intervention concentration measurements). List what documents are mandatory to complete (e.g., participant drug log) and what source data/records will be used to document investigational trial intervention adherence.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
934. Composition.section:intervention.section:adherence.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
936. Composition.section:intervention.section:adherence.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
938. Composition.section:intervention.section:adherence.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
940. Composition.section:intervention.section:adherence.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
942. Composition.section:intervention.section:adherence.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
944. Composition.section:intervention.section:noninvestigationalTherapy
Slice NamenoninvestigationalTherapy
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
946. Composition.section:intervention.section:noninvestigationalTherapy.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
948. Composition.section:intervention.section:noninvestigationalTherapy.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()))
SlicingThis element introduces a set of slices on Composition.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
950. Composition.section:intervention.section:noninvestigationalTherapy.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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
952. Composition.section:intervention.section:noninvestigationalTherapy.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.9 Description of Noninvestigational Trial Intervention"
}
<title value="6.9 Description of Noninvestigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
954. Composition.section:intervention.section:noninvestigationalTherapy.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
956. Composition.section:intervention.section:noninvestigationalTherapy.code.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
958. Composition.section:intervention.section:noninvestigationalTherapy.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
960. Composition.section:intervention.section:noninvestigationalTherapy.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218576",
  "display" : "ICH M11 Protocol Section 6.9 Description of Noninvestigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218576"/>
  <display value="ICH M11 Protocol Section 6.9 Description of Noninvestigational Trial Intervention"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
962. Composition.section:intervention.section:noninvestigationalTherapy.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.9-noninvestigational-interventions"
}
<text value="section6.9-noninvestigational-interventions"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
964. Composition.section:intervention.section:noninvestigationalTherapy.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
966. Composition.section:intervention.section:noninvestigationalTherapy.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
968. Composition.section:intervention.section:noninvestigationalTherapy.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

As stated in Section 6 Trial Intervention and Concomitant Therapy, noninvestigational interventions are pre-specified products used in the trial but are not part of trial objectives and hence, are not investigational trial interventions.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
970. Composition.section:intervention.section:noninvestigationalTherapy.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
972. Composition.section:intervention.section:noninvestigationalTherapy.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
974. Composition.section:intervention.section:noninvestigationalTherapy.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
976. Composition.section:intervention.section:noninvestigationalTherapy.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
978. Composition.section:intervention.section:noninvestigationalTherapy.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.section.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
980. Composition.section:intervention.section:noninvestigationalTherapy.section.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
982. Composition.section:intervention.section:noninvestigationalTherapy.section.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
984. Composition.section:intervention.section:noninvestigationalTherapy.section.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
986. Composition.section:intervention.section:noninvestigationalTherapy.section.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
988. Composition.section:intervention.section:noninvestigationalTherapy.section.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
990. Composition.section:intervention.section:noninvestigationalTherapy.section.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
992. Composition.section:intervention.section:noninvestigationalTherapy.section.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
994. Composition.section:intervention.section:noninvestigationalTherapy.section.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
996. Composition.section:intervention.section:noninvestigationalTherapy.section.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
998. Composition.section:intervention.section:noninvestigationalTherapy.section.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1000. Composition.section:intervention.section:noninvestigationalTherapy.section.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1002. Composition.section:intervention.section:noninvestigationalTherapy.section.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1004. Composition.section:intervention.section:noninvestigationalTherapy.section.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1006. Composition.section:intervention.section:noninvestigationalTherapy.section:background
Slice Namebackground
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
1008. Composition.section:intervention.section:noninvestigationalTherapy.section:background.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
1010. Composition.section:intervention.section:noninvestigationalTherapy.section:background.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1012. Composition.section:intervention.section:noninvestigationalTherapy.section:background.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1014. Composition.section:intervention.section:noninvestigationalTherapy.section:background.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.9.1 Background Trial Intervention"
}
<title value="6.9.1 Background Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1016. Composition.section:intervention.section:noninvestigationalTherapy.section:background.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1018. Composition.section:intervention.section:noninvestigationalTherapy.section:background.code.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
1020. Composition.section:intervention.section:noninvestigationalTherapy.section:background.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1022. Composition.section:intervention.section:noninvestigationalTherapy.section:background.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218577",
  "display" : "ICH M11 Protocol Section 6.9.1 Background Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218577"/>
  <display value="ICH M11 Protocol Section 6.9.1 Background Trial Intervention"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1024. Composition.section:intervention.section:noninvestigationalTherapy.section:background.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.9.1-background-intervention"
}
<text value="section6.9.1-background-intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1026. Composition.section:intervention.section:noninvestigationalTherapy.section:background.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1028. Composition.section:intervention.section:noninvestigationalTherapy.section:background.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1030. Composition.section:intervention.section:noninvestigationalTherapy.section:background.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Describe any background intervention(s), including administration and any conditions for use.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1032. Composition.section:intervention.section:noninvestigationalTherapy.section:background.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1034. Composition.section:intervention.section:noninvestigationalTherapy.section:background.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1036. Composition.section:intervention.section:noninvestigationalTherapy.section:background.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1038. Composition.section:intervention.section:noninvestigationalTherapy.section:background.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1040. Composition.section:intervention.section:noninvestigationalTherapy.section:background.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1042. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue
Slice Namerescue
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
1044. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.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
1046. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1048. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1050. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.9.2 Rescue Therapy"
}
<title value="6.9.2 Rescue Therapy"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1052. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1054. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.code.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
1056. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1058. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218578",
  "display" : "ICH M11 Protocol Section 6.9.2 Rescue Therapy"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218578"/>
  <display value="ICH M11 Protocol Section 6.9.2 Rescue Therapy"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1060. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.9.2-rescue-therapy"
}
<text value="section6.9.2-rescue-therapy"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1062. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1064. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1066. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

List all permitted rescue medications, treatments, and/or procedures, including any relevant instructions on administration and any conditions of use. If administration of rescue therapy leads to the temporary discontinuation of trial intervention or a participant’s withdrawal from the trial, refer to Section 7 Participant Discontinuation of Trial Intervention and Discontinuation or Withdrawal from Trial.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1068. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1070. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1072. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1074. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1076. Composition.section:intervention.section:noninvestigationalTherapy.section:rescue.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1078. Composition.section:intervention.section:noninvestigationalTherapy.section:other
Slice Nameother
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
1080. Composition.section:intervention.section:noninvestigationalTherapy.section:other.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
1082. Composition.section:intervention.section:noninvestigationalTherapy.section:other.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1084. Composition.section:intervention.section:noninvestigationalTherapy.section:other.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1086. Composition.section:intervention.section:noninvestigationalTherapy.section:other.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.9.3 Other Noninvestigational Trial Intervention"
}
<title value="6.9.3 Other Noninvestigational Trial Intervention"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1088. Composition.section:intervention.section:noninvestigationalTherapy.section:other.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1090. Composition.section:intervention.section:noninvestigationalTherapy.section:other.code.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
1092. Composition.section:intervention.section:noninvestigationalTherapy.section:other.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1094. Composition.section:intervention.section:noninvestigationalTherapy.section:other.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218579",
  "display" : "ICH M11 Protocol Section 6.9.3 Other Noninvestigational Trial Intervention"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218579"/>
  <display value="ICH M11 Protocol Section 6.9.3 Other Noninvestigational Trial Intervention"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1096. Composition.section:intervention.section:noninvestigationalTherapy.section:other.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.9.3-other-therapy"
}
<text value="section6.9.3-other-therapy"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1098. Composition.section:intervention.section:noninvestigationalTherapy.section:other.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1100. Composition.section:intervention.section:noninvestigationalTherapy.section:other.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1102. Composition.section:intervention.section:noninvestigationalTherapy.section:other.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

If applicable, describe the use of any other noninvestigational trial intervention, e.g., challenge agents or diagnostics.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1104. Composition.section:intervention.section:noninvestigationalTherapy.section:other.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1106. Composition.section:intervention.section:noninvestigationalTherapy.section:other.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1108. Composition.section:intervention.section:noninvestigationalTherapy.section:other.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1110. Composition.section:intervention.section:noninvestigationalTherapy.section:other.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1112. Composition.section:intervention.section:noninvestigationalTherapy.section:other.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1114. Composition.section:intervention.section:concomitantTherapy
Slice NameconcomitantTherapy
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
1116. Composition.section:intervention.section:concomitantTherapy.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
1118. Composition.section:intervention.section:concomitantTherapy.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()))
SlicingThis element introduces a set of slices on Composition.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1120. Composition.section:intervention.section:concomitantTherapy.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()))
SlicingThis element introduces a set of slices on Composition.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1122. Composition.section:intervention.section:concomitantTherapy.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.10 Concomitant Therapy"
}
<title value="6.10 Concomitant Therapy"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1124. Composition.section:intervention.section:concomitantTherapy.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1126. Composition.section:intervention.section:concomitantTherapy.code.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
1128. Composition.section:intervention.section:concomitantTherapy.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1130. Composition.section:intervention.section:concomitantTherapy.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218580",
  "display" : "ICH M11 Protocol Section 6.10 Concomitant Therapy"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218580"/>
  <display value="ICH M11 Protocol Section 6.10 Concomitant Therapy"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1132. Composition.section:intervention.section:concomitantTherapy.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.10-concomitant-therapy"
}
<text value="section6.10-concomitant-therapy"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1134. Composition.section:intervention.section:concomitantTherapy.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1136. Composition.section:intervention.section:concomitantTherapy.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1138. Composition.section:intervention.section:concomitantTherapy.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Specify the concomitant medications, supplements, complementary and alternative therapies, treatments, and/or procedures which are prohibited or permitted during the trial and include details about when the information will be collected (e.g., during screening, at each visit). When appropriate to separate the content, subheadings may be used.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1140. Composition.section:intervention.section:concomitantTherapy.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1142. Composition.section:intervention.section:concomitantTherapy.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1144. Composition.section:intervention.section:concomitantTherapy.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1146. Composition.section:intervention.section:concomitantTherapy.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1148. Composition.section:intervention.section:concomitantTherapy.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Composition.section.section.section. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ code.text
1150. Composition.section:intervention.section:concomitantTherapy.section.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
1152. Composition.section:intervention.section:concomitantTherapy.section.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1154. Composition.section:intervention.section:concomitantTherapy.section.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1156. Composition.section:intervention.section:concomitantTherapy.section.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1158. Composition.section:intervention.section:concomitantTherapy.section.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1160. Composition.section:intervention.section:concomitantTherapy.section.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1162. Composition.section:intervention.section:concomitantTherapy.section.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1164. Composition.section:intervention.section:concomitantTherapy.section.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1166. Composition.section:intervention.section:concomitantTherapy.section.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1168. Composition.section:intervention.section:concomitantTherapy.section.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1170. Composition.section:intervention.section:concomitantTherapy.section.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1172. Composition.section:intervention.section:concomitantTherapy.section.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1174. Composition.section:intervention.section:concomitantTherapy.section.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1176. Composition.section:intervention.section:concomitantTherapy.section:prohibited
Slice Nameprohibited
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
1178. Composition.section:intervention.section:concomitantTherapy.section:prohibited.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
1180. Composition.section:intervention.section:concomitantTherapy.section:prohibited.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1182. Composition.section:intervention.section:concomitantTherapy.section:prohibited.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1184. Composition.section:intervention.section:concomitantTherapy.section:prohibited.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.10.1 Prohibited Concomitant Therapy"
}
<title value="6.10.1 Prohibited Concomitant Therapy"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1186. Composition.section:intervention.section:concomitantTherapy.section:prohibited.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1188. Composition.section:intervention.section:concomitantTherapy.section:prohibited.code.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
1190. Composition.section:intervention.section:concomitantTherapy.section:prohibited.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1192. Composition.section:intervention.section:concomitantTherapy.section:prohibited.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218581",
  "display" : "ICH M11 Protocol Section 6.10.1 Prohibited Concomitant Therapy"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218581"/>
  <display value="ICH M11 Protocol Section 6.10.1 Prohibited Concomitant Therapy"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1194. Composition.section:intervention.section:concomitantTherapy.section:prohibited.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.10.1-prohibited-concomitant-therapy"
}
<text value="section6.10.1-prohibited-concomitant-therapy"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1196. Composition.section:intervention.section:concomitantTherapy.section:prohibited.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1198. Composition.section:intervention.section:concomitantTherapy.section:prohibited.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1200. Composition.section:intervention.section:concomitantTherapy.section:prohibited.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

If applicable, describe any prohibited concomitant therapy.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1202. Composition.section:intervention.section:concomitantTherapy.section:prohibited.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1204. Composition.section:intervention.section:concomitantTherapy.section:prohibited.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1206. Composition.section:intervention.section:concomitantTherapy.section:prohibited.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1208. Composition.section:intervention.section:concomitantTherapy.section:prohibited.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1210. Composition.section:intervention.section:concomitantTherapy.section:prohibited.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Control0..*
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1212. Composition.section:intervention.section:concomitantTherapy.section:permitted
Slice Namepermitted
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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()))
1214. Composition.section:intervention.section:concomitantTherapy.section:permitted.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
1216. Composition.section:intervention.section:concomitantTherapy.section:permitted.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1218. Composition.section:intervention.section:concomitantTherapy.section:permitted.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1220. Composition.section:intervention.section:concomitantTherapy.section:permitted.title
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

ShortLabel for section (e.g. for ToC)
Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title a required element.

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

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Alternate Namesheader, label, caption
Pattern Value
{
  "title" : "6.10.2 Permitted Concomitant Therapy"
}
<title value="6.10.2 Permitted Concomitant Therapy"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1222. Composition.section:intervention.section:concomitantTherapy.section:permitted.code
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

ShortClassification of section (recommended)
Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section.

Control0..1
BindingFor example codes, see DocumentSectionCodes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes|6.0.0-snapshot1)

Classification of a section of a composition/document.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Provides computable standardized labels to topics within the document.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1224. Composition.section:intervention.section:concomitantTherapy.section:permitted.code.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
1226. Composition.section:intervention.section:concomitantTherapy.section:permitted.code.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()))
SlicingThis element introduces a set of slices on Composition.section.section.section.code.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
1228. Composition.section:intervention.section:concomitantTherapy.section:permitted.code.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

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

Control1..1
TypeCoding
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value
{
  "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
  "code" : "C218582",
  "display" : "ICH M11 Protocol Section 6.10.2 Permitted Concomitant Therapy"
}
<coding>
  <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
  <code value="C218582"/>
  <display value="ICH M11 Protocol Section 6.10.2 Permitted Concomitant Therapy"/>
</coding>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1230. Composition.section:intervention.section:concomitantTherapy.section:permitted.code.text
Definition

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

ShortPlain text representation of the concept
Comments

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

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Value
{
  "text" : "section6.10.2-permitted-concomitant-therapy"
}
<text value="section6.10.2-permitted-concomitant-therapy"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1232. Composition.section:intervention.section:concomitantTherapy.section:permitted.author
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

The actual author of the section when it is not the author of the composition. If author is not specified, the author is assumed to be the author of the parent section or the author of the composition.

ShortWho and/or what authored the section, when the section is authored by someone other than the composition.author
Control0..*
TypeReference(Practitioner, PractitionerRole, CareTeam, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1234. Composition.section:intervention.section:concomitantTherapy.section:permitted.focus
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If no focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

ShortWho/what the section is about, when it is not about the subject of the composition
Comments

Typically, sections in a document are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kinds of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Control0..1
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1236. Composition.section:intervention.section:concomitantTherapy.section:permitted.text
Definition

A human-readable narrative that contains the attested content of the section, 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.

ShortText summary of the section, for human interpretation
Comments

If applicable, describe any permitted concomitant therapy.

Control1..1
This element is affected by the following invariants: cmp-1, cmp-3
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1238. Composition.section:intervention.section:concomitantTherapy.section:permitted.note
Definition

Information about the section contents that is not represented by any of the section entries.

ShortInformation about the section contents that is not represented by any of the section entries
Comments

A comment, general note or annotation not coded elsewhere in the section.

Control0..*
TypeAnnotation
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1240. Composition.section:intervention.section:concomitantTherapy.section:permitted.orderedBy
Definition

Specifies the order applied to the items in the section entries.

ShortOrder of section entries
Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Control0..1
BindingThe codes SHOULD be taken from List Order Codes
(preferred to http://terminology.hl7.org/ValueSet/list-order)

What order applies to the items in the entry.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1242. Composition.section:intervention.section:concomitantTherapy.section:permitted.entry
Definition

A reference to the actual resource from which the narrative in the section is derived.

ShortA reference to data that supports this section
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Control0..*
This element is affected by the following invariants: cmp-1, cmp-2
TypeReference(Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1244. Composition.section:intervention.section:concomitantTherapy.section:permitted.emptyReason
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

ShortWhy the section is empty
Comments

The various reasons for an empty section make a significant difference to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Control0..1
This element is affected by the following invariants: cmp-2
BindingThe codes SHOULD be taken from ListEmptyReasons
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason|6.0.0-snapshot1)

If a section is empty, why it is empty.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
1246. Composition.section:intervention.section:concomitantTherapy.section:permitted.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

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