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: SystematicReview - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 1

Definitions for the systematic-review resource profile

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

0. ResearchStudy
Definition

A research study is a scientific investigation designed to generate health-related knowledge. This can include clinical trials involving human participants (or animals in the case of veterinary clinical trials). These studies may be related to new ways to screen, prevent, diagnose, and treat disease. Research studies may also analyze data collected from individuals in the past (retrospective studies) or future (prospective studies) to understand specific outcomes or trends in particular populations.

ShortInvestigation to increase healthcare-related patient-independent knowledge
Comments

The ResearchStudy Resource may be used for any type of research study, such as public health studies evaluating populations or systematic reviews evaluating research studies, and is not limited to clinical trials or limited to studies of individual people.

Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate NamesStudy
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. ResearchStudy.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. ResearchStudy.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. ResearchStudy.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()))
8. ResearchStudy.extension:author
Slice Nameauthor
Definition

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

ShortWho authored the artifact
Control0..*
TypeExtension(Artifact Author) (Extension Type: ContactDetail)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. ResearchStudy.extension:searchStrategy
Slice NamesearchStrategy
Definition

Link to search terms and sources, using a Group Resource (SearchStrategy Profile).

ShortLink to search terms and sources.
Control0..*
TypeExtension(ResearchStudySearchStrategy) (Extension Type: Reference(SearchStrategy))
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. ResearchStudy.extension:systematicReviewEligibilityCriteria
Slice NamesystematicReviewEligibilityCriteria
Definition

Link to criteria for inclusion of studies in the systematic review, using a Group Resource (StudyEligibilityCriteria Profile).

ShortLink to inclusion and exclusion criteria for studies.
Control0..1
TypeExtension(ResearchStudySystematicReviewEligibilityCriteria) (Extension Type: Reference(SystematicReviewEligibilityCriteria))
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. ResearchStudy.extension:numberOfStudiesIdentified
Slice NamenumberOfStudiesIdentified
Definition

Number of studies found on search to be evaluated for inclusion.

ShortNumber of studies found on search.
Control0..1
TypeExtension(ResearchStudyNumberOfStudiesIdentified) (Extension Type: unsignedInt)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. ResearchStudy.extension:numberOfStudiesIncluded
Slice NamenumberOfStudiesIncluded
Definition

Number of studies selected for inclusion.

ShortNumber of studies selected for inclusion.
Control0..1
TypeExtension(ResearchStudyNumberOfStudiesIncluded) (Extension Type: unsignedInt)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. ResearchStudy.extension:includedStudy
Slice NameincludedStudy
Definition

Link to a research study included in the systematic review.

ShortLink to a research study included in the systematic review.
Control0..*
TypeExtension(ResearchStudyIncludedStudy) (Extension Type: Reference(PublicationRecord, Composition, ResearchStudy))
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. ResearchStudy.extension:excludedStudy
Slice NameexcludedStudy
Definition

Link to a research study excluded from the systematic review.

ShortLink to a research study excluded from the systematic review.
Control0..*
TypeExtension(ResearchStudyExcludedStudy) (Extension Type: Reference(PublicationRecord, Composition, ResearchStudy))
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. ResearchStudy.extension:studyRegistration
Slice NamestudyRegistration
Definition

Dates for study registration activities.

ShortDates for study registration activities
Comments

Used to separate study registration activities from study progress status.

Control0..*
TypeExtension(ResearchStudy Study Registration) (Complex Extension)
Is Modifierfalse
Must Supportfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. ResearchStudy.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 ResearchStudy.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 26. ResearchStudy.status
    Definition

    The publication state of the resource (not of the study).

    Shortdraft | active | retired | unknown
    Control1..1
    BindingThe codes SHALL be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status|6.0.0-ballot5
    (required to http://hl7.org/fhir/ValueSet/publication-status|6.0.0-ballot5)

    Codes that convey the current publication status of the research study resource.

    Typecode
    Is Modifiertrue because This element is labeled 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
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. ResearchStudy.phase
    Definition

    The stage in the progression of a therapy from initial experimental use in humans in clinical trials to post-market evaluation.

    ShortClassifier used for clinical trials
    Control0..01
    BindingThe codes SHOULD be taken from ResearchStudyPhasehttp://terminology.hl7.org/ValueSet/research-study-phase
    (preferred to http://terminology.hl7.org/ValueSet/research-study-phase)

    Classifiers of clinical trial progression for human use.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. ResearchStudy.recruitment
    Definition

    Target or actual group of participants enrolled in study.

    ShortTarget or actual group of participants enrolled in study
    Control0..01
    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()))

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

    0. ResearchStudy
    2. ResearchStudy.extension:publicationStatus
    Slice NamepublicationStatus
    Control0..1
    TypeExtension(ArtifactPublicationStatus) (Extension Type: CodeableConcept)
    4. ResearchStudy.extension:author
    Slice Nameauthor
    Control0..*
    TypeExtension(Artifact Author) (Extension Type: ContactDetail)
    6. ResearchStudy.extension:searchStrategy
    Slice NamesearchStrategy
    Control0..*
    TypeExtension(ResearchStudySearchStrategy) (Extension Type: Reference(SearchStrategy))
    8. ResearchStudy.extension:systematicReviewEligibilityCriteria
    Slice NamesystematicReviewEligibilityCriteria
    Control0..1
    TypeExtension(ResearchStudySystematicReviewEligibilityCriteria) (Extension Type: Reference(SystematicReviewEligibilityCriteria))
    10. ResearchStudy.extension:numberOfStudiesIdentified
    Slice NamenumberOfStudiesIdentified
    Control0..1
    TypeExtension(ResearchStudyNumberOfStudiesIdentified) (Extension Type: unsignedInt)
    12. ResearchStudy.extension:numberOfStudiesIncluded
    Slice NamenumberOfStudiesIncluded
    Control0..1
    TypeExtension(ResearchStudyNumberOfStudiesIncluded) (Extension Type: unsignedInt)
    14. ResearchStudy.extension:includedStudy
    Slice NameincludedStudy
    Control0..*
    TypeExtension(ResearchStudyIncludedStudy) (Extension Type: Reference(PublicationRecord, Composition, ResearchStudy))
    16. ResearchStudy.extension:excludedStudy
    Slice NameexcludedStudy
    Control0..*
    TypeExtension(ResearchStudyExcludedStudy) (Extension Type: Reference(PublicationRecord, Composition, ResearchStudy))
    18. ResearchStudy.extension:studyRegistration
    Slice NamestudyRegistration
    Control0..*
    TypeExtension(ResearchStudy Study Registration) (Complex Extension)
    20. ResearchStudy.relatesTo
    22. ResearchStudy.relatesTo.extension:quotation
    Slice Namequotation
    Control0..1
    TypeExtension(RelatesToWithQuotation) (Extension Type: markdown)
    24. ResearchStudy.relatesTo.extension:classifier
    Slice Nameclassifier
    Control0..1
    TypeExtension(RelatesToClassifier) (Extension Type: CodeableConcept)
    26. ResearchStudy.phase
    Control0..0
    28. ResearchStudy.recruitment
    Control0..0

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

    0. ResearchStudy
    Definition

    A research study is a scientific investigation designed to generate health-related knowledge. This can include clinical trials involving human participants (or animals in the case of veterinary clinical trials). These studies may be related to new ways to screen, prevent, diagnose, and treat disease. Research studies may also analyze data collected from individuals in the past (retrospective studies) or future (prospective studies) to understand specific outcomes or trends in particular populations.

    ShortInvestigation to increase healthcare-related patient-independent knowledge
    Comments

    The ResearchStudy Resource may be used for any type of research study, such as public health studies evaluating populations or systematic reviews evaluating research studies, and is not limited to clinical trials or limited to studies of individual people.

    Control0..*
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Alternate NamesStudy
    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. ResearchStudy.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. ResearchStudy.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. ResearchStudy.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. ResearchStudy.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-ballot5)

    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. ResearchStudy.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. ResearchStudy.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. ResearchStudy.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 ResearchStudy.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 16. ResearchStudy.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()))
      18. ResearchStudy.extension:author
      Slice Nameauthor
      Definition

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

      ShortWho authored the artifact
      Control0..*
      TypeExtension(Artifact Author) (Extension Type: ContactDetail)
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. ResearchStudy.extension:searchStrategy
      Slice NamesearchStrategy
      Definition

      Link to search terms and sources, using a Group Resource (SearchStrategy Profile).

      ShortLink to search terms and sources.
      Control0..*
      TypeExtension(ResearchStudySearchStrategy) (Extension Type: Reference(SearchStrategy))
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. ResearchStudy.extension:systematicReviewEligibilityCriteria
      Slice NamesystematicReviewEligibilityCriteria
      Definition

      Link to criteria for inclusion of studies in the systematic review, using a Group Resource (StudyEligibilityCriteria Profile).

      ShortLink to inclusion and exclusion criteria for studies.
      Control0..1
      TypeExtension(ResearchStudySystematicReviewEligibilityCriteria) (Extension Type: Reference(SystematicReviewEligibilityCriteria))
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. ResearchStudy.extension:numberOfStudiesIdentified
      Slice NamenumberOfStudiesIdentified
      Definition

      Number of studies found on search to be evaluated for inclusion.

      ShortNumber of studies found on search.
      Control0..1
      TypeExtension(ResearchStudyNumberOfStudiesIdentified) (Extension Type: unsignedInt)
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. ResearchStudy.extension:numberOfStudiesIncluded
      Slice NamenumberOfStudiesIncluded
      Definition

      Number of studies selected for inclusion.

      ShortNumber of studies selected for inclusion.
      Control0..1
      TypeExtension(ResearchStudyNumberOfStudiesIncluded) (Extension Type: unsignedInt)
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. ResearchStudy.extension:includedStudy
      Slice NameincludedStudy
      Definition

      Link to a research study included in the systematic review.

      ShortLink to a research study included in the systematic review.
      Control0..*
      TypeExtension(ResearchStudyIncludedStudy) (Extension Type: Reference(PublicationRecord, Composition, ResearchStudy))
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. ResearchStudy.extension:excludedStudy
      Slice NameexcludedStudy
      Definition

      Link to a research study excluded from the systematic review.

      ShortLink to a research study excluded from the systematic review.
      Control0..*
      TypeExtension(ResearchStudyExcludedStudy) (Extension Type: Reference(PublicationRecord, Composition, ResearchStudy))
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. ResearchStudy.extension:studyRegistration
      Slice NamestudyRegistration
      Definition

      Dates for study registration activities.

      ShortDates for study registration activities
      Comments

      Used to separate study registration activities from study progress status.

      Control0..*
      TypeExtension(ResearchStudy Study Registration) (Complex Extension)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. ResearchStudy.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 ResearchStudy.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 36. ResearchStudy.url
        Definition

        Canonical identifier for this study resource, represented as a globally unique URI.

        ShortCanonical identifier for this study resource
        Control0..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. ResearchStudy.identifier
        Definition

        Identifiers assigned to this research study by the sponsor or other systems.

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

        Allows identification of the research study as it is known by various participating systems and in a way that remains consistent across servers.

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

        The business version for the study record.

        ShortThe business version for the study record
        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
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. ResearchStudy.name
        Definition

        Name for this study (computer friendly).

        ShortName for this study (computer friendly)
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. ResearchStudy.title
        Definition

        The human readable name of the research study.

        ShortHuman readable name of the study
        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()))
        46. ResearchStudy.label
        Definition

        Additional names for the study.

        ShortAdditional names for the study
        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()))
        48. ResearchStudy.label.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
        50. ResearchStudy.label.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 ResearchStudy.label.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 52. ResearchStudy.label.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 ResearchStudy.label.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 54. ResearchStudy.label.type
            Definition

            Kind of name.

            Shortprimary | official | scientific | plain-language | subtitle | short-title | acronym | earlier-title | language | auto-translated | human-use | machine-use | duplicate-uid
            Control0..1
            BindingThe codes SHOULD be taken from Title Type
            (preferred to http://terminology.hl7.org/ValueSet/title-type)

            desc.

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

            The name.

            ShortThe name
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. ResearchStudy.label.language
            Definition

            Used to express the specific language of the title.

            ShortUsed to express the specific language
            Control0..1
            BindingThe codes SHALL be taken from AllLanguages
            (required to http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot5)

            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()))
            60. ResearchStudy.protocol
            Definition

            The set of steps expected to be performed as part of the execution of the study.

            ShortSteps followed in executing study
            Control0..*
            TypeReference(PlanDefinition)
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. ResearchStudy.partOf
            Definition

            A larger research study of which this particular study is a component or step.

            ShortPart of larger study
            Control0..*
            TypeReference(ResearchStudy)
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Requirements

            Allows breaking a study into components (e.g. by study site) each with their own PI, status, enrollment, etc.

            Alternate Namescontainer
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. ResearchStudy.citeAs
            Definition

            Display of the bibliographic citation of this ResearchStudy.

            ShortHow to cite this ResearchStudy
            Control0..1
            Typemarkdown
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. ResearchStudy.relatesTo
            Definition

            Relationships that this ResearchStudy has with other FHIR or non-FHIR resources that already exist.

            ShortRelationships to other Resources
            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()))
            68. ResearchStudy.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
            70. ResearchStudy.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 ResearchStudy.relatesTo.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 72. ResearchStudy.relatesTo.extension:quotation
              Slice Namequotation
              Definition

              Specification of a portion quoted from the related artifact.

              ShortQuoted portion from related artifact
              Control0..1
              TypeExtension(RelatesToWithQuotation) (Extension Type: markdown)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              74. ResearchStudy.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()))
              76. ResearchStudy.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 ResearchStudy.relatesTo.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 78. ResearchStudy.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()))
                80. ResearchStudy.relatesTo.target[x]
                Definition

                The artifact that is related to this ResearchStudy Resource.

                ShortThe artifact that is related to this ResearchStudy
                Comments

                A targetReference using a DocumentReference allows providing metadata regarding the referenced document.

                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. ResearchStudy.date
                Definition

                The date (and optionally time) when the ResearchStudy Resource was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the ResearchStudy Resource changes.

                ShortDate the resource last changed
                Control0..1
                TypedateTime
                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()))
                84. ResearchStudy.status
                Definition

                The publication state of the resource (not of the study).

                Shortdraft | active | retired | unknown
                Control1..1
                BindingThe codes SHALL be taken from PublicationStatus
                (required to http://hl7.org/fhir/ValueSet/publication-status|6.0.0-ballot5)

                Codes that convey the current publication status of the research study resource.

                Typecode
                Is Modifiertrue because This element is labeled 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
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                86. ResearchStudy.purposeType
                Definition

                The type of study based upon the intent of the study activities. A classification of the intent of the study.

                Shorttreatment | prevention | diagnostic | supportive-care | screening | health-services-research | basic-science | device-feasibility
                Control0..*
                BindingThe codes SHOULD be taken from ResearchStudyPurposeType
                (preferred to http://terminology.hl7.org/ValueSet/research-study-purpose-type)

                Codes for the main intent of the study.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                88. ResearchStudy.phase
                Definition

                The stage in the progression of a therapy from initial experimental use in humans in clinical trials to post-market evaluation.

                ShortClassifier used for clinical trials
                Control0..0
                BindingThe codes SHOULD be taken from ResearchStudyPhase
                (preferred to http://terminology.hl7.org/ValueSet/research-study-phase)

                Classifiers of clinical trial progression for human use.

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

                Codes categorizing the type of study such as investigational vs. observational, type of blinding, type of randomization, safety vs. efficacy, etc.

                ShortClassifications of the study design characteristics
                Comments

                See the Evidence Based Medicine on FHIR Implementation Guide (https://hl7.org/fhir/uv/ebm) for Extensible and Preferred value sets for evidence-related terminologies.

                Control0..*
                BindingThe codes SHOULD be taken from Study Design
                (preferred to http://terminology.hl7.org/ValueSet/study-design)

                This is a set of terms for study design characteristics.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                92. ResearchStudy.focus
                Definition

                The medication(s), food(s), therapy(ies), device(s) or other concerns or interventions that the study is seeking to gain more information about.

                ShortDrugs, devices, etc. under study
                Control0..*
                BindingFor example codes, see ResearchStudyFocusType
                (example to http://hl7.org/fhir/ValueSet/research-study-focus-type|6.0.0-ballot5)

                Some example codes of research study focus

                TypeCodeableReference(Medication, MedicinalProductDefinition, SubstanceDefinition, DeviceDefinition, PlanDefinition)
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                94. ResearchStudy.condition
                Definition

                The condition that is the focus of the study. For example, In a study to examine risk factors for Lupus, might have as an inclusion criterion "healthy volunteer", but the target condition code would be a Lupus SNOMED code.

                ShortCondition being studied
                Control0..*
                BindingFor example codes, see ConditionProblemDiagnosisCodes
                (example to http://hl7.org/fhir/ValueSet/condition-code|6.0.0-ballot5)

                Identification of the condition or diagnosis.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                96. ResearchStudy.keyword
                Definition

                Key terms to aid in searching for or filtering the study.

                ShortUsed to search for the study
                Control0..*
                BindingFor example codes, see ResearchStudyFocusType
                (example to http://hl7.org/fhir/ValueSet/research-study-focus-type|6.0.0-ballot5)

                Some example codes.

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

                A country, state or other area where the study is taking place rather than its precise geographic location or address.

                ShortGeographic area for the study
                Control0..*
                BindingThe codes SHOULD be taken from Jurisdiction ValueSet
                (preferred to http://terminology.hl7.org/ValueSet/jurisdiction)

                Countries and regions within which this artifact is targeted for use.

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

                A brief text for explaining the study.

                ShortBrief text explaining the study
                Control0..1
                Typemarkdown
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                102. ResearchStudy.description
                Definition

                A detailed and human-readable narrative of the study. E.g., study abstract.

                ShortDetailed narrative of the study
                Control0..1
                Typemarkdown
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                104. ResearchStudy.period
                Definition

                Identifies the start date and the expected (or actual, depending on status) end date for the study.

                ShortWhen the study began and ended
                Control0..1
                TypePeriod
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Alternate Namestiming
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                106. ResearchStudy.site
                Definition

                A facility in which study activities are conducted.

                ShortFacility where study activities are conducted
                Control0..*
                TypeReference(Location, ResearchStudy, Organization)
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                108. ResearchStudy.note
                Definition

                Comments made about the study by the performer, subject or other participants.

                ShortComments made about the study
                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. ResearchStudy.classifier
                Definition

                Additional grouping mechanism or categorization of a research study. Example: FDA regulated device, FDA regulated drug, MPG Paragraph 23b (a German legal requirement), IRB-exempt, etc. Implementation Note: do not use the classifier element to support existing semantics that are already supported thru explicit elements in the resource.

                ShortClassification for the study
                Control0..*
                BindingFor example codes, see ResearchStudyClassifiers
                (example to http://hl7.org/fhir/ValueSet/research-study-classifiers|6.0.0-ballot5)

                desc.

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

                Sponsors, collaborators, and other parties.

                ShortSponsors, collaborators, and other parties
                Comments

                For a Sponsor or a PrincipalInvestigator use the dedicated attributes provided.

                Control0..*
                TypeBackboneElement
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Requirements

                While there are explicit attributes for a Sponsor and a PrincipalInvestigator many trial record a range of other organizations and individuals in key roles.

                Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
                114. ResearchStudy.associatedParty.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
                116. ResearchStudy.associatedParty.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 ResearchStudy.associatedParty.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 118. ResearchStudy.associatedParty.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 ResearchStudy.associatedParty.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 120. ResearchStudy.associatedParty.name
                    Definition

                    Name of associated party.

                    ShortName of associated party
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supportfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    122. ResearchStudy.associatedParty.role
                    Definition

                    Type of association.

                    Shortsponsor | lead-sponsor | sponsor-investigator | primary-investigator | collaborator | funding-source | general-contact | recruitment-contact | sub-investigator | study-chair | irb | data-monitoring
                    Control1..1
                    BindingThe codes SHOULD be taken from Research Study Party Role
                    (preferred to http://terminology.hl7.org/ValueSet/research-study-party-role)

                    This is a ResearchStudy's party role.

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

                    Identifies the start date and the end date of the associated party in the role.

                    ShortWhen active in the role
                    Comments

                    The cardinality is 0..* due to the fact that an associated party may be intermittently active in a given role over multiple time periods.

                    Control0..*
                    TypePeriod
                    Is Modifierfalse
                    Must Supportfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    126. ResearchStudy.associatedParty.classifier
                    Definition

                    A categorization other than role for the associated party.

                    Shortnih | fda | government | nonprofit | academic | industry
                    Control0..*
                    BindingFor example codes, see ResearchStudyPartyOrgType
                    (example to http://hl7.org/fhir/ValueSet/research-study-party-organization-type|6.0.0-ballot5)

                    A characterization or type of the entity.

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

                    Individual or organization associated with study (use practitionerRole to specify their organisation).

                    ShortIndividual or organization associated with study (use practitionerRole to specify their organisation)
                    Comments

                    Suggestions of a better attribute name are appreciated

                    Control0..1
                    TypeReference(Practitioner, PractitionerRole, Organization)
                    Is Modifierfalse
                    Must Supportfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    130. ResearchStudy.progressStatus
                    Definition

                    Dates for status changes for the conduct of the study, or study registry and administrative actions.

                    ShortDates for status changes for the conduct of the study, or study registry and administrative actions
                    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()))
                    132. ResearchStudy.progressStatus.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
                    134. ResearchStudy.progressStatus.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 ResearchStudy.progressStatus.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 136. ResearchStudy.progressStatus.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 ResearchStudy.progressStatus.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 138. ResearchStudy.progressStatus.state
                        Definition

                        Label for status or state (e.g. recruitment status).

                        ShortLabel for status or state (e.g. recruitment status)
                        Control1..1
                        BindingThe codes SHOULD be taken from Research Study Status
                        (preferred to http://terminology.hl7.org/ValueSet/research-study-status)

                        Codes that convey the current status of the research study.

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

                        An indication of whether or not the date is a known date when the state changed or will change. A value of true indicates a known date. A value of false indicates an estimated date.

                        ShortActual if true else anticipated
                        Control0..1
                        Typeboolean
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        142. ResearchStudy.progressStatus.period
                        Definition

                        Date range.

                        ShortDate range
                        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()))
                        144. ResearchStudy.whyStopped
                        Definition

                        A description and/or code explaining the premature termination of the study.

                        Shortaccrual-goal-met | closed-due-to-toxicity | closed-due-to-lack-of-study-progress | temporarily-closed-per-study-design
                        Control0..1
                        BindingFor example codes, see ResearchStudyReasonStopped
                        (example to http://terminology.hl7.org/ValueSet/research-study-reason-stopped)

                        Codes for why the study ended prematurely.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supportfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        146. ResearchStudy.recruitment
                        Definition

                        Target or actual group of participants enrolled in study.

                        ShortTarget or actual group of participants enrolled in study
                        Control0..0
                        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()))
                        156. ResearchStudy.comparisonGroup
                        Definition

                        Describes an expected event or sequence of events for one of the subjects of a study. E.g. for a living subject: exposure to drug A, wash-out, exposure to drug B, wash-out, follow-up. E.g. for a stability study: {store sample from lot A at 25 degrees for 1 month}, {store sample from lot A at 40 degrees for 1 month}.

                        ShortDefined path through the study for a subject
                        Comments

                        In many clinical trials this is refered to as the ARM of the study, but such a term is not used in other sorts of trials even when there is a comparison between two or more groups.

                        Control0..*
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Alternate Namesarm
                        Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
                        158. ResearchStudy.comparisonGroup.id
                        Definition

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

                        ShortUnique id for inter-element referencing
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        160. ResearchStudy.comparisonGroup.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 ResearchStudy.comparisonGroup.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 162. ResearchStudy.comparisonGroup.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 ResearchStudy.comparisonGroup.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 164. ResearchStudy.comparisonGroup.targetNumber
                            Definition

                            Estimated total number of participants to be enrolled in the comparison group.

                            ShortEstimated total number of participants to be enrolled in the comparison group
                            Control0..1
                            TypeunsignedInt
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            166. ResearchStudy.comparisonGroup.actualNumber
                            Definition

                            Actual total number of participants enrolled in the comparison group.

                            ShortActual total number of participants enrolled in the comparison group
                            Control0..1
                            TypeunsignedInt
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            168. ResearchStudy.comparisonGroup.eligibility
                            Definition

                            Inclusion and exclusion criteria for the comparison group as a subset of the eligibility for the overall study. The referenced Group Resource should have a membership element value of either 'definitional' or 'conceptual'.

                            ShortInclusion and exclusion criteria for the comparison group
                            Control0..1
                            TypeReference(Group)
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            170. ResearchStudy.comparisonGroup.observedGroup
                            Definition

                            Group of participants who were enrolled in the comparison group as a subset of those enrolled in the overall study. The referenced Group Resource should have a membership element value of 'enumerated'.

                            ShortGroup of participants who were enrolled in the comparison group
                            Control0..1
                            TypeReference(Group)
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            172. ResearchStudy.comparisonGroup.name
                            Definition

                            A simple label for the comparison Group.

                            ShortA simple label for the comparison Group
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            174. ResearchStudy.comparisonGroup.description
                            Definition

                            Description of the comparison Group.

                            ShortDescription of the comparison Group
                            Control0..1
                            Typemarkdown
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            176. ResearchStudy.objective
                            Definition

                            A goal that the study is aiming to achieve in terms of a scientific question to be answered by the analysis of data collected during the study.

                            ShortA goal for the study
                            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()))
                            178. ResearchStudy.objective.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
                            180. ResearchStudy.objective.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 ResearchStudy.objective.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 182. ResearchStudy.objective.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 ResearchStudy.objective.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 184. ResearchStudy.objective.name
                                Definition

                                Unique, human-readable label for this objective of the study.

                                ShortLabel for the objective
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                186. ResearchStudy.objective.type
                                Definition

                                The kind of study objective.

                                Shortprimary | secondary | exploratory
                                Control0..1
                                BindingThe codes SHOULD be taken from ResearchStudyObjectiveType
                                (preferred to http://terminology.hl7.org/ValueSet/research-study-objective-type)

                                Codes for the kind of study objective.

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

                                Free text description of the objective of the study. This is what the study is trying to achieve rather than how it is going to achieve it (see ResearchStudy.description).

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

                                An "outcome measure", "endpoint", "effect measure" or "measure of effect" is a specific measurement or observation used to quantify the effect of experimental variables on the participants in a study, or for observational studies, to describe patterns of diseases or traits or associations with exposures, risk factors or treatment.

                                ShortA variable measured during the study
                                Comments

                                A study may have multiple distinct outcome measures that can be used to assess the overall goal for a study. The goal of a study is in the objective whereas the metric by which the goal is assessed is the outcomeMeasure. Examples: Time to Local Recurrence (TLR), Disease-free Survival (DFS), 30 Day Mortality, Systolic BP

                                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()))
                                192. ResearchStudy.objective.outcomeMeasure.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
                                194. ResearchStudy.objective.outcomeMeasure.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 ResearchStudy.objective.outcomeMeasure.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 196. ResearchStudy.objective.outcomeMeasure.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 ResearchStudy.objective.outcomeMeasure.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 198. ResearchStudy.objective.outcomeMeasure.name
                                    Definition

                                    Label for the outcome measure.

                                    ShortLabel for the outcome measure
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    200. ResearchStudy.objective.outcomeMeasure.type
                                    Definition

                                    The kind of outcome measure.

                                    Shortprimary | secondary | exploratory
                                    Control0..1
                                    BindingThe codes SHOULD be taken from ResearchStudyObjectiveType
                                    (preferred to http://terminology.hl7.org/ValueSet/research-study-objective-type)

                                    defn.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    202. ResearchStudy.objective.outcomeMeasure.description
                                    Definition

                                    Description of the outcome measure.

                                    ShortDescription of the outcome measure
                                    Control0..1
                                    Typemarkdown
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    204. ResearchStudy.objective.outcomeMeasure.endpoint
                                    Definition

                                    Definition of the outcome measure.

                                    ShortDefinition of the outcome measure
                                    Control1..1
                                    TypeReference(EvidenceVariable)
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    206. ResearchStudy.objective.outcomeMeasure.population
                                    Definition

                                    Population for this estimand.

                                    ShortPopulation for this estimand
                                    Control0..1
                                    TypeReference(Group)
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    208. ResearchStudy.objective.outcomeMeasure.intervention
                                    Definition

                                    Comparison group of interest.

                                    ShortComparison group of interest
                                    Comments

                                    To re-use and reference a Group represented in ResearchStudy.comparisonGroup.eligibility, one may include the Group Resource in ResearchStudy.contained and then reference the same (internal) Group by its id

                                    Control0..1
                                    TypeReference(Group)
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    210. ResearchStudy.objective.outcomeMeasure.comparator
                                    Definition

                                    Comparison group for comparison.

                                    ShortComparison group for comparison
                                    Comments

                                    To re-use and reference a Group represented in ResearchStudy.comparisonGroup.eligibility, one may include the Group Resource in ResearchStudy.contained and then reference the same (internal) Group by its id

                                    Control0..1
                                    TypeReference(Group)
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    212. ResearchStudy.objective.outcomeMeasure.summaryMeasure
                                    Definition

                                    Statistical measure for treatment effect estimate.

                                    ShortStatistical measure for treatment effect estimate
                                    Comments

                                    See the Evidence Based Medicine on FHIR Implementation Guide (https://hl7.org/fhir/uv/ebm) for Extensible and Preferred value sets for evidence-related terminologies.

                                    Control0..1
                                    BindingFor example codes, see Statistic Type
                                    (example to http://terminology.hl7.org/ValueSet/statistic-type)

                                    The type of a statistic, e.g. relative risk or mean.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    214. ResearchStudy.objective.outcomeMeasure.endpointAnalysisPlan
                                    Definition

                                    The planned statistical model for analysis of a single endpoint.

                                    ShortStatistical analysis plan for a single endpoint
                                    Control0..1
                                    TypeReference(Evidence)
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    216. ResearchStudy.objective.outcomeMeasure.eventHandling
                                    Definition

                                    Handling of intercurrent event.

                                    ShortHandling of intercurrent event
                                    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()))
                                    218. ResearchStudy.objective.outcomeMeasure.eventHandling.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
                                    220. ResearchStudy.objective.outcomeMeasure.eventHandling.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 ResearchStudy.objective.outcomeMeasure.eventHandling.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 222. ResearchStudy.objective.outcomeMeasure.eventHandling.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 ResearchStudy.objective.outcomeMeasure.eventHandling.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 224. ResearchStudy.objective.outcomeMeasure.eventHandling.event
                                        Definition

                                        The event.

                                        ShortThe event
                                        Control0..1
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        226. ResearchStudy.objective.outcomeMeasure.eventHandling.group
                                        Definition

                                        The group that is affected by this event handling.

                                        ShortThe group that is affected by this event handling
                                        Control0..1
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        228. ResearchStudy.objective.outcomeMeasure.eventHandling.handling
                                        Definition

                                        How the data is handled.

                                        ShortHow the data is handled
                                        Control0..1
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        230. ResearchStudy.objective.outcomeMeasure.eventHandling.description
                                        Definition

                                        Text summary of event handling.

                                        ShortText summary of event handling
                                        Control0..1
                                        Typemarkdown
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        232. ResearchStudy.result
                                        Definition

                                        Link to one or more sets of results generated by the study. Could also link to a research registry holding the results such as ClinicalTrials.gov.

                                        ShortLink to results generated during the study
                                        Control0..*
                                        TypeReference(Composition, DiagnosticReport, DocumentReference, Evidence)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))