This page is part of the FHIR Specification (v5.0.0-draft-final: Final QA Preview for R5 - see ballot notes). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

14.13 Resource Evidence - Content

Clinical Decision Support icon

Work Group

Maturity Level: 1

Trial Use

Security Category: Business

Compartments: Not linked to any defined compartments

The Evidence Resource provides a machine-interpretable expression of an evidence concept including the evidence variables (e.g., population, exposures/interventions, comparators, outcomes, measured variables, confounding variables), the statistics, and the certainty of this evidence.

14.13.1 Scope and Usage

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

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

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

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

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

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

14.13.2 Boundaries and Relationships

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

14.13.3 References to this Resource

Resource References: EvidenceVariable

Structure

Name	Flags	Card.	Type	Description & Constraints
Evidence	TU		DomainResource	Single evidence bit + Warning: Name should be usable as an identifier for the module by machine processing applications such as code generation Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension Interfaces Implemented: MetadataResource
url	Σ C	0..1	uri	Canonical identifier for this evidence, represented as a globally unique URI + Warning: URL should not contain \| or # - these characters make processing canonical references problematic
identifier	Σ	0..*	Identifier	Additional identifier for the summary
version	Σ	0..1	string	Business version of this summary
versionAlgorithm[x]	Σ	0..1		How to compare versions Binding: Version Algorithm (Extensible)
versionAlgorithmString			string
versionAlgorithmCoding			Coding
name	C	0..1	string	Name for this summary (machine friendly)
title	Σ T	0..1	string	Name for this summary (human friendly)
citeAs[x]		0..1		Citation for this evidence
citeAsReference			Reference(Citation)
citeAsMarkdown			markdown
status	?!Σ	1..1	code	draft \| active \| retired \| unknown Binding: PublicationStatus (Required)
experimental		0..1	boolean	For testing purposes, not real usage
date	Σ	0..1	dateTime	Date last changed
approvalDate		0..1	date	When the summary was approved by publisher
lastReviewDate		0..1	date	When the summary was last reviewed by the publisher
publisher	Σ T	0..1	string	Name of the publisher/steward (organization or individual)
contact	Σ	0..*	ContactDetail	Contact details for the publisher
author	Σ	0..*	ContactDetail	Who authored the content
editor		0..*	ContactDetail	Who edited the content
reviewer		0..*	ContactDetail	Who reviewed the content
endorser	Σ	0..*	ContactDetail	Who endorsed the content
useContext	Σ	0..*	UsageContext	The context that the content is intended to support
purpose		0..1	markdown	Why this Evidence is defined
copyright		0..1	markdown	Use and/or publishing restrictions
copyrightLabel	T	0..1	string	Copyright holder and year(s)
relatedArtifact		0..*	RelatedArtifact	Link or citation to artifact associated with the summary
description	T	0..1	markdown	Description of the particular summary
assertion	T	0..1	markdown	Declarative description of the Evidence
note		0..*	Annotation	Footnotes and/or explanatory notes
variableDefinition		1..*	BackboneElement	Evidence variable such as population, exposure, or outcome
description		0..1	markdown	A text description or summary of the variable
note		0..*	Annotation	Footnotes and/or explanatory notes
variableRole	Σ	1..1	CodeableConcept	population \| subpopulation \| exposure \| referenceExposure \| measuredVariable \| confounder Binding: Evidence Variable Role (Extensible)
observed	Σ	0..1	Reference(Group \| EvidenceVariable)	Definition of the actual variable related to the statistic(s)
intended		0..1	Reference(Group \| EvidenceVariable)	Definition of the intended variable related to the Evidence
directnessMatch		0..1	CodeableConcept	low \| moderate \| high \| exact Binding: Evidence Directness (Extensible)
synthesisType		0..1	CodeableConcept	The method to combine studies Binding: Synthesis Type (Extensible)
studyDesign		0..*	CodeableConcept	The design of the study that produced this evidence Binding: Study Design (Extensible)
statistic		0..*	BackboneElement	Values and parameters for a single statistic
description		0..1	markdown	Description of content
note		0..*	Annotation	Footnotes and/or explanatory notes
statisticType		0..1	CodeableConcept	Type of statistic, e.g., relative risk Binding: Statistic Type (Extensible)
category		0..1	CodeableConcept	Associated category for categorical variable
quantity		0..1	Quantity	Statistic value
numberOfEvents		0..1	unsignedInt	The number of events associated with the statistic
numberAffected		0..1	unsignedInt	The number of participants affected
sampleSize		0..1	BackboneElement	Number of samples in the statistic
description		0..1	markdown	Textual description of sample size for statistic
note		0..*	Annotation	Footnote or explanatory note about the sample size
numberOfStudies		0..1	unsignedInt	Number of contributing studies
numberOfParticipants		0..1	unsignedInt	Cumulative number of participants
knownDataCount		0..1	unsignedInt	Number of participants with known results for measured variables
attributeEstimate		0..*	BackboneElement	An attribute of the Statistic
description		0..1	markdown	Textual description of the attribute estimate
note		0..*	Annotation	Footnote or explanatory note about the estimate
type		0..1	CodeableConcept	The type of attribute estimate, e.g., confidence interval or p value Binding: Attribute Estimate Type (Extensible)
quantity		0..1	Quantity	The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure
level		0..1	decimal	Level of confidence interval, e.g., 0.95 for 95% confidence interval
range		0..1	Range	Lower and upper bound values of the attribute estimate
attributeEstimate		0..*	see attributeEstimate	A nested attribute estimate; which is the attribute estimate of an attribute estimate
modelCharacteristic		0..*	BackboneElement	An aspect of the statistical model
code		1..1	CodeableConcept	Model specification Binding: Statistic Model Code (Extensible)
value		0..1	SimpleQuantity	Numerical value to complete model specification
variable		0..*	BackboneElement	A variable adjusted for in the adjusted analysis
variableDefinition		1..1	Reference(Group \| EvidenceVariable)	Description of the variable
handling		0..1	code	continuous \| dichotomous \| ordinal \| polychotomous Binding: Evidence Variable Handling (Required)
valueCategory		0..*	CodeableConcept	Description for grouping of ordinal or polychotomous variables
valueQuantity		0..*	Quantity	Discrete value for grouping of ordinal or polychotomous variables
valueRange		0..*	Range	Range of values for grouping of ordinal or polychotomous variables
attributeEstimate		0..*	see attributeEstimate	An attribute of the statistic used as a model characteristic
certainty		0..*	BackboneElement	Certainty or quality of the evidence
description		0..1	markdown	Textual description of certainty
note		0..*	Annotation	Footnotes and/or explanatory notes
type		0..1	CodeableConcept	Aspect of certainty being rated Binding: Evidence Certainty Type (Extensible)
rating		0..1	CodeableConcept	Assessment or judgement of the aspect Binding: Evidence Certainty Rating (Extensible)
rater		0..1	string	Individual or group who did the rating
subcomponent		0..*	see certainty	A domain or subdomain of certainty
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<Evidence xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Canonical identifier for this evidence, represented as a globally unique URI -->
 <identifier><!-- 0..* Identifier Additional identifier for the summary --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of this summary -->
 <versionAlgorithm[x]><!-- 0..1 string|Coding How to compare versions --></versionAlgorithm[x]>
 <name value="[string]"/><!-- I 0..1 Name for this summary (machine friendly) -->
 <title value="[string]"/><!-- 0..1 Name for this summary (human friendly) -->
 <citeAs[x]><!-- 0..1 Reference(Citation)|markdown Citation for this evidence --></citeAs[x]>
 <status value="[code]"/><!-- 1..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing purposes, not real usage -->
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <approvalDate value="[date]"/><!-- 0..1 When the summary was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the summary was last reviewed by the publisher -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher/steward (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <author><!-- 0..* ContactDetail Who authored the content --></author>
 <editor><!-- 0..* ContactDetail Who edited the content --></editor>
 <reviewer><!-- 0..* ContactDetail Who reviewed the content --></reviewer>
 <endorser><!-- 0..* ContactDetail Who endorsed the content --></endorser>
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <purpose value="[markdown]"/><!-- 0..1 Why this Evidence is defined -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <copyrightLabel value="[string]"/><!-- 0..1 Copyright holder and year(s) -->
 <relatedArtifact><!-- 0..* RelatedArtifact Link or citation to artifact associated with the summary --></relatedArtifact>
 <description value="[markdown]"/><!-- 0..1 Description of the particular summary -->
 <assertion value="[markdown]"/><!-- 0..1 Declarative description of the Evidence -->
 <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
 <variableDefinition>  <!-- 1..* Evidence variable such as population, exposure, or outcome -->
  <description value="[markdown]"/><!-- 0..1 A text description or summary of the variable -->
  <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
  <variableRole><!-- 1..1 CodeableConcept population | subpopulation | exposure | referenceExposure | measuredVariable | confounder --></variableRole>
  <observed><!-- 0..1 Reference(EvidenceVariable|Group) Definition of the actual variable related to the statistic(s) --></observed>
  <intended><!-- 0..1 Reference(EvidenceVariable|Group) Definition of the intended variable related to the Evidence --></intended>
  <directnessMatch><!-- 0..1 CodeableConcept low | moderate | high | exact --></directnessMatch>
 </variableDefinition>
 <synthesisType><!-- 0..1 CodeableConcept The method to combine studies --></synthesisType>
 <studyDesign><!-- 0..* CodeableConcept The design of the study that produced this evidence --></studyDesign>
 <statistic>  <!-- 0..* Values and parameters for a single statistic -->
  <description value="[markdown]"/><!-- 0..1 Description of content -->
  <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
  <statisticType><!-- 0..1 CodeableConcept Type of statistic, e.g., relative risk --></statisticType>
  <category><!-- 0..1 CodeableConcept Associated category for categorical variable --></category>
  <quantity><!-- 0..1 Quantity Statistic value --></quantity>
  <numberOfEvents value="[unsignedInt]"/><!-- 0..1 The number of events associated with the statistic -->
  <numberAffected value="[unsignedInt]"/><!-- 0..1 The number of participants affected -->
  <sampleSize>  <!-- 0..1 Number of samples in the statistic -->
   <description value="[markdown]"/><!-- 0..1 Textual description of sample size for statistic -->
   <note><!-- 0..* Annotation Footnote or explanatory note about the sample size --></note>
   <numberOfStudies value="[unsignedInt]"/><!-- 0..1 Number of contributing studies -->
   <numberOfParticipants value="[unsignedInt]"/><!-- 0..1 Cumulative number of participants -->
   <knownDataCount value="[unsignedInt]"/><!-- 0..1 Number of participants with known results for measured variables -->
  </sampleSize>
  <attributeEstimate>  <!-- 0..* An attribute of the Statistic -->
   <description value="[markdown]"/><!-- 0..1 Textual description of the attribute estimate -->
   <note><!-- 0..* Annotation Footnote or explanatory note about the estimate --></note>
   <type><!-- 0..1 CodeableConcept The type of attribute estimate, e.g., confidence interval or p value --></type>
   <quantity><!-- 0..1 Quantity The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure --></quantity>
   <level value="[decimal]"/><!-- 0..1 Level of confidence interval, e.g., 0.95 for 95% confidence interval -->
   <range><!-- 0..1 Range Lower and upper bound values of the attribute estimate --></range>
   <attributeEstimate><!-- 0..* Content as for Evidence.statistic.attributeEstimate A nested attribute estimate; which is the attribute estimate of an attribute estimate --></attributeEstimate>
  </attributeEstimate>
  <modelCharacteristic>  <!-- 0..* An aspect of the statistical model -->
   <code><!-- 1..1 CodeableConcept Model specification --></code>
   <value><!-- 0..1 Quantity(SimpleQuantity) Numerical value to complete model specification --></value>
   <variable>  <!-- 0..* A variable adjusted for in the adjusted analysis -->
    <variableDefinition><!-- 1..1 Reference(EvidenceVariable|Group) Description of the variable --></variableDefinition>
    <handling value="[code]"/><!-- 0..1 continuous | dichotomous | ordinal | polychotomous -->
    <valueCategory><!-- 0..* CodeableConcept Description for grouping of ordinal or polychotomous variables --></valueCategory>
    <valueQuantity><!-- 0..* Quantity Discrete value for grouping of ordinal or polychotomous variables --></valueQuantity>
    <valueRange><!-- 0..* Range Range of values for grouping of ordinal or polychotomous variables --></valueRange>
   </variable>
   <attributeEstimate><!-- 0..* Content as for Evidence.statistic.attributeEstimate An attribute of the statistic used as a model characteristic --></attributeEstimate>
  </modelCharacteristic>
 </statistic>
 <certainty>  <!-- 0..* Certainty or quality of the evidence -->
  <description value="[markdown]"/><!-- 0..1 Textual description of certainty -->
  <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
  <type><!-- 0..1 CodeableConcept Aspect of certainty being rated --></type>
  <rating><!-- 0..1 CodeableConcept Assessment or judgement of the aspect --></rating>
  <rater value="[string]"/><!-- 0..1 Individual or group who did the rating -->
  <subcomponent><!-- 0..* Content as for Evidence.certainty A domain or subdomain of certainty --></subcomponent>
 </certainty>
</Evidence>

JSON Template

{
  "resourceType" : "Evidence",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Canonical identifier for this evidence, represented as a globally unique URI
  "identifier" : [{ Identifier }], // Additional identifier for the summary
  "version" : "<string>", // Business version of this summary
  // versionAlgorithm[x]: How to compare versions. One of these 2:
  "versionAlgorithmString" : "<string>",
  "versionAlgorithmCoding" : { Coding },
  "name" : "<string>", // I Name for this summary (machine friendly)
  "title" : "<string>", // Name for this summary (human friendly)
  // citeAs[x]: Citation for this evidence. One of these 2:
  "citeAsReference" : { Reference(Citation) },
  "citeAsMarkdown" : "<markdown>",
  "status" : "<code>", // R!  draft | active | retired | unknown
  "experimental" : <boolean>, // For testing purposes, not real usage
  "date" : "<dateTime>", // Date last changed
  "approvalDate" : "<date>", // When the summary was approved by publisher
  "lastReviewDate" : "<date>", // When the summary was last reviewed by the publisher
  "publisher" : "<string>", // Name of the publisher/steward (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "author" : [{ ContactDetail }], // Who authored the content
  "editor" : [{ ContactDetail }], // Who edited the content
  "reviewer" : [{ ContactDetail }], // Who reviewed the content
  "endorser" : [{ ContactDetail }], // Who endorsed the content
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "purpose" : "<markdown>", // Why this Evidence is defined
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "copyrightLabel" : "<string>", // Copyright holder and year(s)
  "relatedArtifact" : [{ RelatedArtifact }], // Link or citation to artifact associated with the summary
  "description" : "<markdown>", // Description of the particular summary
  "assertion" : "<markdown>", // Declarative description of the Evidence
  "note" : [{ Annotation }], // Footnotes and/or explanatory notes
  "variableDefinition" : [{ // R!  Evidence variable such as population, exposure, or outcome
    "description" : "<markdown>", // A text description or summary of the variable
    "note" : [{ Annotation }], // Footnotes and/or explanatory notes
    "variableRole" : { CodeableConcept }, // R!  population | subpopulation | exposure | referenceExposure | measuredVariable | confounder
    "observed" : { Reference(EvidenceVariable|Group) }, // Definition of the actual variable related to the statistic(s)
    "intended" : { Reference(EvidenceVariable|Group) }, // Definition of the intended variable related to the Evidence
    "directnessMatch" : { CodeableConcept } // low | moderate | high | exact
  }],
  "synthesisType" : { CodeableConcept }, // The method to combine studies
  "studyDesign" : [{ CodeableConcept }], // The design of the study that produced this evidence
  "statistic" : [{ // Values and parameters for a single statistic
    "description" : "<markdown>", // Description of content
    "note" : [{ Annotation }], // Footnotes and/or explanatory notes
    "statisticType" : { CodeableConcept }, // Type of statistic, e.g., relative risk
    "category" : { CodeableConcept }, // Associated category for categorical variable
    "quantity" : { Quantity }, // Statistic value
    "numberOfEvents" : "<unsignedInt>", // The number of events associated with the statistic
    "numberAffected" : "<unsignedInt>", // The number of participants affected
    "sampleSize" : { // Number of samples in the statistic
      "description" : "<markdown>", // Textual description of sample size for statistic
      "note" : [{ Annotation }], // Footnote or explanatory note about the sample size
      "numberOfStudies" : "<unsignedInt>", // Number of contributing studies
      "numberOfParticipants" : "<unsignedInt>", // Cumulative number of participants
      "knownDataCount" : "<unsignedInt>" // Number of participants with known results for measured variables
    },
    "attributeEstimate" : [{ // An attribute of the Statistic
      "description" : "<markdown>", // Textual description of the attribute estimate
      "note" : [{ Annotation }], // Footnote or explanatory note about the estimate
      "type" : { CodeableConcept }, // The type of attribute estimate, e.g., confidence interval or p value
      "quantity" : { Quantity }, // The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure
      "level" : <decimal>, // Level of confidence interval, e.g., 0.95 for 95% confidence interval
      "range" : { Range }, // Lower and upper bound values of the attribute estimate
      "attributeEstimate" : [{ Content as for Evidence.statistic.attributeEstimate }] // A nested attribute estimate; which is the attribute estimate of an attribute estimate
    }],
    "modelCharacteristic" : [{ // An aspect of the statistical model
      "code" : { CodeableConcept }, // R!  Model specification
      "value" : { Quantity(SimpleQuantity) }, // Numerical value to complete model specification
      "variable" : [{ // A variable adjusted for in the adjusted analysis
        "variableDefinition" : { Reference(EvidenceVariable|Group) }, // R!  Description of the variable
        "handling" : "<code>", // continuous | dichotomous | ordinal | polychotomous
        "valueCategory" : [{ CodeableConcept }], // Description for grouping of ordinal or polychotomous variables
        "valueQuantity" : [{ Quantity }], // Discrete value for grouping of ordinal or polychotomous variables
        "valueRange" : [{ Range }] // Range of values for grouping of ordinal or polychotomous variables
      }],
      "attributeEstimate" : [{ Content as for Evidence.statistic.attributeEstimate }] // An attribute of the statistic used as a model characteristic
    }]
  }],
  "certainty" : [{ // Certainty or quality of the evidence
    "description" : "<markdown>", // Textual description of certainty
    "note" : [{ Annotation }], // Footnotes and/or explanatory notes
    "type" : { CodeableConcept }, // Aspect of certainty being rated
    "rating" : { CodeableConcept }, // Assessment or judgement of the aspect
    "rater" : "<string>", // Individual or group who did the rating
    "subcomponent" : [{ Content as for Evidence.certainty }] // A domain or subdomain of certainty
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:Evidence;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:url [ uri ] ; # 0..1 Canonical identifier for this evidence, represented as a globally unique URI
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Additional identifier for the summary
  fhir:version [ string ] ; # 0..1 Business version of this summary
  # versionAlgorithm[x] : 0..1 How to compare versions. One of these 2
    fhir:versionAlgorithm [  a fhir:string ; string ]
    fhir:versionAlgorithm [  a fhir:Coding ; Coding ]
  fhir:name [ string ] ; # 0..1 I Name for this summary (machine friendly)
  fhir:title [ string ] ; # 0..1 Name for this summary (human friendly)
  # citeAs[x] : 0..1 Citation for this evidence. One of these 2
    fhir:citeAs [  a fhir:Reference ; Reference(Citation) ]
    fhir:citeAs [  a fhir:markdown ; markdown ]
  fhir:status [ code ] ; # 1..1 draft | active | retired | unknown
  fhir:experimental [ boolean ] ; # 0..1 For testing purposes, not real usage
  fhir:date [ dateTime ] ; # 0..1 Date last changed
  fhir:approvalDate [ date ] ; # 0..1 When the summary was approved by publisher
  fhir:lastReviewDate [ date ] ; # 0..1 When the summary was last reviewed by the publisher
  fhir:publisher [ string ] ; # 0..1 Name of the publisher/steward (organization or individual)
  fhir:contact  ( [ ContactDetail ] ... ) ; # 0..* Contact details for the publisher
  fhir:author  ( [ ContactDetail ] ... ) ; # 0..* Who authored the content
  fhir:editor  ( [ ContactDetail ] ... ) ; # 0..* Who edited the content
  fhir:reviewer  ( [ ContactDetail ] ... ) ; # 0..* Who reviewed the content
  fhir:endorser  ( [ ContactDetail ] ... ) ; # 0..* Who endorsed the content
  fhir:useContext  ( [ UsageContext ] ... ) ; # 0..* The context that the content is intended to support
  fhir:purpose [ markdown ] ; # 0..1 Why this Evidence is defined
  fhir:copyright [ markdown ] ; # 0..1 Use and/or publishing restrictions
  fhir:copyrightLabel [ string ] ; # 0..1 Copyright holder and year(s)
  fhir:relatedArtifact  ( [ RelatedArtifact ] ... ) ; # 0..* Link or citation to artifact associated with the summary
  fhir:description [ markdown ] ; # 0..1 Description of the particular summary
  fhir:assertion [ markdown ] ; # 0..1 Declarative description of the Evidence
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
  fhir:variableDefinition ( [ # 1..* Evidence variable such as population, exposure, or outcome
    fhir:description [ markdown ] ; # 0..1 A text description or summary of the variable
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
    fhir:variableRole [ CodeableConcept ] ; # 1..1 population | subpopulation | exposure | referenceExposure | measuredVariable | confounder
    fhir:observed [ Reference(EvidenceVariable|Group) ] ; # 0..1 Definition of the actual variable related to the statistic(s)
    fhir:intended [ Reference(EvidenceVariable|Group) ] ; # 0..1 Definition of the intended variable related to the Evidence
    fhir:directnessMatch [ CodeableConcept ] ; # 0..1 low | moderate | high | exact
  ] ... ) ;
  fhir:synthesisType [ CodeableConcept ] ; # 0..1 The method to combine studies
  fhir:studyDesign  ( [ CodeableConcept ] ... ) ; # 0..* The design of the study that produced this evidence
  fhir:statistic ( [ # 0..* Values and parameters for a single statistic
    fhir:description [ markdown ] ; # 0..1 Description of content
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
    fhir:statisticType [ CodeableConcept ] ; # 0..1 Type of statistic, e.g., relative risk
    fhir:category [ CodeableConcept ] ; # 0..1 Associated category for categorical variable
    fhir:quantity [ Quantity ] ; # 0..1 Statistic value
    fhir:numberOfEvents [ unsignedInt ] ; # 0..1 The number of events associated with the statistic
    fhir:numberAffected [ unsignedInt ] ; # 0..1 The number of participants affected
    fhir:sampleSize [ # 0..1 Number of samples in the statistic
      fhir:description [ markdown ] ; # 0..1 Textual description of sample size for statistic
      fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnote or explanatory note about the sample size
      fhir:numberOfStudies [ unsignedInt ] ; # 0..1 Number of contributing studies
      fhir:numberOfParticipants [ unsignedInt ] ; # 0..1 Cumulative number of participants
      fhir:knownDataCount [ unsignedInt ] ; # 0..1 Number of participants with known results for measured variables
    ] ;
    fhir:attributeEstimate ( [ # 0..* An attribute of the Statistic
      fhir:description [ markdown ] ; # 0..1 Textual description of the attribute estimate
      fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnote or explanatory note about the estimate
      fhir:type [ CodeableConcept ] ; # 0..1 The type of attribute estimate, e.g., confidence interval or p value
      fhir:quantity [ Quantity ] ; # 0..1 The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure
      fhir:level [ decimal ] ; # 0..1 Level of confidence interval, e.g., 0.95 for 95% confidence interval
      fhir:range [ Range ] ; # 0..1 Lower and upper bound values of the attribute estimate
      fhir:attributeEstimate  ( [ See Evidence.statistic.attributeEstimate ] ... ) ; # 0..* A nested attribute estimate; which is the attribute estimate of an attribute estimate
    ] ... ) ;
    fhir:modelCharacteristic ( [ # 0..* An aspect of the statistical model
      fhir:code [ CodeableConcept ] ; # 1..1 Model specification
      fhir:value [ Quantity(SimpleQuantity) ] ; # 0..1 Numerical value to complete model specification
      fhir:variable ( [ # 0..* A variable adjusted for in the adjusted analysis
        fhir:variableDefinition [ Reference(EvidenceVariable|Group) ] ; # 1..1 Description of the variable
        fhir:handling [ code ] ; # 0..1 continuous | dichotomous | ordinal | polychotomous
        fhir:valueCategory  ( [ CodeableConcept ] ... ) ; # 0..* Description for grouping of ordinal or polychotomous variables
        fhir:valueQuantity  ( [ Quantity ] ... ) ; # 0..* Discrete value for grouping of ordinal or polychotomous variables
        fhir:valueRange  ( [ Range ] ... ) ; # 0..* Range of values for grouping of ordinal or polychotomous variables
      ] ... ) ;
      fhir:attributeEstimate  ( [ See Evidence.statistic.attributeEstimate ] ... ) ; # 0..* An attribute of the statistic used as a model characteristic
    ] ... ) ;
  ] ... ) ;
  fhir:certainty ( [ # 0..* Certainty or quality of the evidence
    fhir:description [ markdown ] ; # 0..1 Textual description of certainty
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
    fhir:type [ CodeableConcept ] ; # 0..1 Aspect of certainty being rated
    fhir:rating [ CodeableConcept ] ; # 0..1 Assessment or judgement of the aspect
    fhir:rater [ string ] ; # 0..1 Individual or group who did the rating
    fhir:subcomponent  ( [ See Evidence.certainty ] ... ) ; # 0..* A domain or subdomain of certainty
  ] ... ) ;
]

Changes since R4

Evidence

Evidence.versionAlgorithm[x]

Added Element

Evidence.citeAs[x]

Added Element

Evidence.experimental

Added Element

Evidence.purpose

Added Element

Evidence.copyrightLabel

Added Element

Evidence.assertion

Added Element

Evidence.variableDefinition

Added Mandatory Element

Evidence.variableDefinition.description

Added Element

Evidence.variableDefinition.note

Added Element

Evidence.variableDefinition.variableRole

Added Mandatory Element

Evidence.variableDefinition.observed

Added Element

Evidence.variableDefinition.intended

Added Element

Evidence.variableDefinition.directnessMatch

Added Element

Evidence.synthesisType

Added Element

Evidence.studyDesign

Added Element

Evidence.statistic

Added Element

Evidence.statistic.description

Added Element

Evidence.statistic.note

Added Element

Evidence.statistic.statisticType

Added Element

Evidence.statistic.category

Added Element

Evidence.statistic.quantity

Added Element

Evidence.statistic.numberOfEvents

Added Element

Evidence.statistic.numberAffected

Added Element

Evidence.statistic.sampleSize

Added Element

Evidence.statistic.sampleSize.description

Added Element

Evidence.statistic.sampleSize.note

Added Element

Evidence.statistic.sampleSize.numberOfStudies

Added Element

Evidence.statistic.sampleSize.numberOfParticipants

Added Element

Evidence.statistic.sampleSize.knownDataCount

Added Element

Evidence.statistic.attributeEstimate

Added Element

Evidence.statistic.attributeEstimate.description

Added Element

Evidence.statistic.attributeEstimate.note

Added Element

Evidence.statistic.attributeEstimate.type

Added Element

Evidence.statistic.attributeEstimate.quantity

Added Element

Evidence.statistic.attributeEstimate.level

Added Element

Evidence.statistic.attributeEstimate.range

Added Element

Evidence.statistic.attributeEstimate.attributeEstimate

Added Element

Evidence.statistic.modelCharacteristic

Added Element

Evidence.statistic.modelCharacteristic.code

Added Mandatory Element

Evidence.statistic.modelCharacteristic.value

Added Element

Evidence.statistic.modelCharacteristic.variable

Added Element

Evidence.statistic.modelCharacteristic.variable.variableDefinition

Added Mandatory Element

Evidence.statistic.modelCharacteristic.variable.handling

Added Element

Evidence.statistic.modelCharacteristic.variable.valueCategory

Added Element

Evidence.statistic.modelCharacteristic.variable.valueQuantity

Added Element

Evidence.statistic.modelCharacteristic.variable.valueRange

Added Element

Evidence.statistic.modelCharacteristic.attributeEstimate

Added Element

Evidence.certainty

Added Element

Evidence.certainty.description

Added Element

Evidence.certainty.note

Added Element

Evidence.certainty.type

Added Element

Evidence.certainty.rating

Added Element

Evidence.certainty.rater

Added Element

Evidence.certainty.subcomponent

Added Element

Evidence.shortTitle

deleted

Evidence.subtitle

deleted

Evidence.jurisdiction

deleted

Evidence.effectivePeriod

deleted

Evidence.topic

deleted

Evidence.exposureBackground

deleted

Evidence.exposureVariant

deleted

Evidence.outcome

deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

Structure

Name	Flags	Card.	Type	Description & Constraints
Evidence	TU		DomainResource	Single evidence bit + Warning: Name should be usable as an identifier for the module by machine processing applications such as code generation Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension Interfaces Implemented: MetadataResource
url	Σ C	0..1	uri	Canonical identifier for this evidence, represented as a globally unique URI + Warning: URL should not contain \| or # - these characters make processing canonical references problematic
identifier	Σ	0..*	Identifier	Additional identifier for the summary
version	Σ	0..1	string	Business version of this summary
versionAlgorithm[x]	Σ	0..1		How to compare versions Binding: Version Algorithm (Extensible)
versionAlgorithmString			string
versionAlgorithmCoding			Coding
name	C	0..1	string	Name for this summary (machine friendly)
title	Σ T	0..1	string	Name for this summary (human friendly)
citeAs[x]		0..1		Citation for this evidence
citeAsReference			Reference(Citation)
citeAsMarkdown			markdown
status	?!Σ	1..1	code	draft \| active \| retired \| unknown Binding: PublicationStatus (Required)
experimental		0..1	boolean	For testing purposes, not real usage
date	Σ	0..1	dateTime	Date last changed
approvalDate		0..1	date	When the summary was approved by publisher
lastReviewDate		0..1	date	When the summary was last reviewed by the publisher
publisher	Σ T	0..1	string	Name of the publisher/steward (organization or individual)
contact	Σ	0..*	ContactDetail	Contact details for the publisher
author	Σ	0..*	ContactDetail	Who authored the content
editor		0..*	ContactDetail	Who edited the content
reviewer		0..*	ContactDetail	Who reviewed the content
endorser	Σ	0..*	ContactDetail	Who endorsed the content
useContext	Σ	0..*	UsageContext	The context that the content is intended to support
purpose		0..1	markdown	Why this Evidence is defined
copyright		0..1	markdown	Use and/or publishing restrictions
copyrightLabel	T	0..1	string	Copyright holder and year(s)
relatedArtifact		0..*	RelatedArtifact	Link or citation to artifact associated with the summary
description	T	0..1	markdown	Description of the particular summary
assertion	T	0..1	markdown	Declarative description of the Evidence
note		0..*	Annotation	Footnotes and/or explanatory notes
variableDefinition		1..*	BackboneElement	Evidence variable such as population, exposure, or outcome
description		0..1	markdown	A text description or summary of the variable
note		0..*	Annotation	Footnotes and/or explanatory notes
variableRole	Σ	1..1	CodeableConcept	population \| subpopulation \| exposure \| referenceExposure \| measuredVariable \| confounder Binding: Evidence Variable Role (Extensible)
observed	Σ	0..1	Reference(Group \| EvidenceVariable)	Definition of the actual variable related to the statistic(s)
intended		0..1	Reference(Group \| EvidenceVariable)	Definition of the intended variable related to the Evidence
directnessMatch		0..1	CodeableConcept	low \| moderate \| high \| exact Binding: Evidence Directness (Extensible)
synthesisType		0..1	CodeableConcept	The method to combine studies Binding: Synthesis Type (Extensible)
studyDesign		0..*	CodeableConcept	The design of the study that produced this evidence Binding: Study Design (Extensible)
statistic		0..*	BackboneElement	Values and parameters for a single statistic
description		0..1	markdown	Description of content
note		0..*	Annotation	Footnotes and/or explanatory notes
statisticType		0..1	CodeableConcept	Type of statistic, e.g., relative risk Binding: Statistic Type (Extensible)
category		0..1	CodeableConcept	Associated category for categorical variable
quantity		0..1	Quantity	Statistic value
numberOfEvents		0..1	unsignedInt	The number of events associated with the statistic
numberAffected		0..1	unsignedInt	The number of participants affected
sampleSize		0..1	BackboneElement	Number of samples in the statistic
description		0..1	markdown	Textual description of sample size for statistic
note		0..*	Annotation	Footnote or explanatory note about the sample size
numberOfStudies		0..1	unsignedInt	Number of contributing studies
numberOfParticipants		0..1	unsignedInt	Cumulative number of participants
knownDataCount		0..1	unsignedInt	Number of participants with known results for measured variables
attributeEstimate		0..*	BackboneElement	An attribute of the Statistic
description		0..1	markdown	Textual description of the attribute estimate
note		0..*	Annotation	Footnote or explanatory note about the estimate
type		0..1	CodeableConcept	The type of attribute estimate, e.g., confidence interval or p value Binding: Attribute Estimate Type (Extensible)
quantity		0..1	Quantity	The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure
level		0..1	decimal	Level of confidence interval, e.g., 0.95 for 95% confidence interval
range		0..1	Range	Lower and upper bound values of the attribute estimate
attributeEstimate		0..*	see attributeEstimate	A nested attribute estimate; which is the attribute estimate of an attribute estimate
modelCharacteristic		0..*	BackboneElement	An aspect of the statistical model
code		1..1	CodeableConcept	Model specification Binding: Statistic Model Code (Extensible)
value		0..1	SimpleQuantity	Numerical value to complete model specification
variable		0..*	BackboneElement	A variable adjusted for in the adjusted analysis
variableDefinition		1..1	Reference(Group \| EvidenceVariable)	Description of the variable
handling		0..1	code	continuous \| dichotomous \| ordinal \| polychotomous Binding: Evidence Variable Handling (Required)
valueCategory		0..*	CodeableConcept	Description for grouping of ordinal or polychotomous variables
valueQuantity		0..*	Quantity	Discrete value for grouping of ordinal or polychotomous variables
valueRange		0..*	Range	Range of values for grouping of ordinal or polychotomous variables
attributeEstimate		0..*	see attributeEstimate	An attribute of the statistic used as a model characteristic
certainty		0..*	BackboneElement	Certainty or quality of the evidence
description		0..1	markdown	Textual description of certainty
note		0..*	Annotation	Footnotes and/or explanatory notes
type		0..1	CodeableConcept	Aspect of certainty being rated Binding: Evidence Certainty Type (Extensible)
rating		0..1	CodeableConcept	Assessment or judgement of the aspect Binding: Evidence Certainty Rating (Extensible)
rater		0..1	string	Individual or group who did the rating
subcomponent		0..*	see certainty	A domain or subdomain of certainty
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<Evidence xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Canonical identifier for this evidence, represented as a globally unique URI -->
 <identifier><!-- 0..* Identifier Additional identifier for the summary --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of this summary -->
 <versionAlgorithm[x]><!-- 0..1 string|Coding How to compare versions --></versionAlgorithm[x]>
 <name value="[string]"/><!-- I 0..1 Name for this summary (machine friendly) -->
 <title value="[string]"/><!-- 0..1 Name for this summary (human friendly) -->
 <citeAs[x]><!-- 0..1 Reference(Citation)|markdown Citation for this evidence --></citeAs[x]>
 <status value="[code]"/><!-- 1..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing purposes, not real usage -->
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <approvalDate value="[date]"/><!-- 0..1 When the summary was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the summary was last reviewed by the publisher -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher/steward (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <author><!-- 0..* ContactDetail Who authored the content --></author>
 <editor><!-- 0..* ContactDetail Who edited the content --></editor>
 <reviewer><!-- 0..* ContactDetail Who reviewed the content --></reviewer>
 <endorser><!-- 0..* ContactDetail Who endorsed the content --></endorser>
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <purpose value="[markdown]"/><!-- 0..1 Why this Evidence is defined -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <copyrightLabel value="[string]"/><!-- 0..1 Copyright holder and year(s) -->
 <relatedArtifact><!-- 0..* RelatedArtifact Link or citation to artifact associated with the summary --></relatedArtifact>
 <description value="[markdown]"/><!-- 0..1 Description of the particular summary -->
 <assertion value="[markdown]"/><!-- 0..1 Declarative description of the Evidence -->
 <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
 <variableDefinition>  <!-- 1..* Evidence variable such as population, exposure, or outcome -->
  <description value="[markdown]"/><!-- 0..1 A text description or summary of the variable -->
  <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
  <variableRole><!-- 1..1 CodeableConcept population | subpopulation | exposure | referenceExposure | measuredVariable | confounder --></variableRole>
  <observed><!-- 0..1 Reference(EvidenceVariable|Group) Definition of the actual variable related to the statistic(s) --></observed>
  <intended><!-- 0..1 Reference(EvidenceVariable|Group) Definition of the intended variable related to the Evidence --></intended>
  <directnessMatch><!-- 0..1 CodeableConcept low | moderate | high | exact --></directnessMatch>
 </variableDefinition>
 <synthesisType><!-- 0..1 CodeableConcept The method to combine studies --></synthesisType>
 <studyDesign><!-- 0..* CodeableConcept The design of the study that produced this evidence --></studyDesign>
 <statistic>  <!-- 0..* Values and parameters for a single statistic -->
  <description value="[markdown]"/><!-- 0..1 Description of content -->
  <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
  <statisticType><!-- 0..1 CodeableConcept Type of statistic, e.g., relative risk --></statisticType>
  <category><!-- 0..1 CodeableConcept Associated category for categorical variable --></category>
  <quantity><!-- 0..1 Quantity Statistic value --></quantity>
  <numberOfEvents value="[unsignedInt]"/><!-- 0..1 The number of events associated with the statistic -->
  <numberAffected value="[unsignedInt]"/><!-- 0..1 The number of participants affected -->
  <sampleSize>  <!-- 0..1 Number of samples in the statistic -->
   <description value="[markdown]"/><!-- 0..1 Textual description of sample size for statistic -->
   <note><!-- 0..* Annotation Footnote or explanatory note about the sample size --></note>
   <numberOfStudies value="[unsignedInt]"/><!-- 0..1 Number of contributing studies -->
   <numberOfParticipants value="[unsignedInt]"/><!-- 0..1 Cumulative number of participants -->
   <knownDataCount value="[unsignedInt]"/><!-- 0..1 Number of participants with known results for measured variables -->
  </sampleSize>
  <attributeEstimate>  <!-- 0..* An attribute of the Statistic -->
   <description value="[markdown]"/><!-- 0..1 Textual description of the attribute estimate -->
   <note><!-- 0..* Annotation Footnote or explanatory note about the estimate --></note>
   <type><!-- 0..1 CodeableConcept The type of attribute estimate, e.g., confidence interval or p value --></type>
   <quantity><!-- 0..1 Quantity The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure --></quantity>
   <level value="[decimal]"/><!-- 0..1 Level of confidence interval, e.g., 0.95 for 95% confidence interval -->
   <range><!-- 0..1 Range Lower and upper bound values of the attribute estimate --></range>
   <attributeEstimate><!-- 0..* Content as for Evidence.statistic.attributeEstimate A nested attribute estimate; which is the attribute estimate of an attribute estimate --></attributeEstimate>
  </attributeEstimate>
  <modelCharacteristic>  <!-- 0..* An aspect of the statistical model -->
   <code><!-- 1..1 CodeableConcept Model specification --></code>
   <value><!-- 0..1 Quantity(SimpleQuantity) Numerical value to complete model specification --></value>
   <variable>  <!-- 0..* A variable adjusted for in the adjusted analysis -->
    <variableDefinition><!-- 1..1 Reference(EvidenceVariable|Group) Description of the variable --></variableDefinition>
    <handling value="[code]"/><!-- 0..1 continuous | dichotomous | ordinal | polychotomous -->
    <valueCategory><!-- 0..* CodeableConcept Description for grouping of ordinal or polychotomous variables --></valueCategory>
    <valueQuantity><!-- 0..* Quantity Discrete value for grouping of ordinal or polychotomous variables --></valueQuantity>
    <valueRange><!-- 0..* Range Range of values for grouping of ordinal or polychotomous variables --></valueRange>
   </variable>
   <attributeEstimate><!-- 0..* Content as for Evidence.statistic.attributeEstimate An attribute of the statistic used as a model characteristic --></attributeEstimate>
  </modelCharacteristic>
 </statistic>
 <certainty>  <!-- 0..* Certainty or quality of the evidence -->
  <description value="[markdown]"/><!-- 0..1 Textual description of certainty -->
  <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
  <type><!-- 0..1 CodeableConcept Aspect of certainty being rated --></type>
  <rating><!-- 0..1 CodeableConcept Assessment or judgement of the aspect --></rating>
  <rater value="[string]"/><!-- 0..1 Individual or group who did the rating -->
  <subcomponent><!-- 0..* Content as for Evidence.certainty A domain or subdomain of certainty --></subcomponent>
 </certainty>
</Evidence>

JSON Template

{
  "resourceType" : "Evidence",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Canonical identifier for this evidence, represented as a globally unique URI
  "identifier" : [{ Identifier }], // Additional identifier for the summary
  "version" : "<string>", // Business version of this summary
  // versionAlgorithm[x]: How to compare versions. One of these 2:
  "versionAlgorithmString" : "<string>",
  "versionAlgorithmCoding" : { Coding },
  "name" : "<string>", // I Name for this summary (machine friendly)
  "title" : "<string>", // Name for this summary (human friendly)
  // citeAs[x]: Citation for this evidence. One of these 2:
  "citeAsReference" : { Reference(Citation) },
  "citeAsMarkdown" : "<markdown>",
  "status" : "<code>", // R!  draft | active | retired | unknown
  "experimental" : <boolean>, // For testing purposes, not real usage
  "date" : "<dateTime>", // Date last changed
  "approvalDate" : "<date>", // When the summary was approved by publisher
  "lastReviewDate" : "<date>", // When the summary was last reviewed by the publisher
  "publisher" : "<string>", // Name of the publisher/steward (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "author" : [{ ContactDetail }], // Who authored the content
  "editor" : [{ ContactDetail }], // Who edited the content
  "reviewer" : [{ ContactDetail }], // Who reviewed the content
  "endorser" : [{ ContactDetail }], // Who endorsed the content
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "purpose" : "<markdown>", // Why this Evidence is defined
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "copyrightLabel" : "<string>", // Copyright holder and year(s)
  "relatedArtifact" : [{ RelatedArtifact }], // Link or citation to artifact associated with the summary
  "description" : "<markdown>", // Description of the particular summary
  "assertion" : "<markdown>", // Declarative description of the Evidence
  "note" : [{ Annotation }], // Footnotes and/or explanatory notes
  "variableDefinition" : [{ // R!  Evidence variable such as population, exposure, or outcome
    "description" : "<markdown>", // A text description or summary of the variable
    "note" : [{ Annotation }], // Footnotes and/or explanatory notes
    "variableRole" : { CodeableConcept }, // R!  population | subpopulation | exposure | referenceExposure | measuredVariable | confounder
    "observed" : { Reference(EvidenceVariable|Group) }, // Definition of the actual variable related to the statistic(s)
    "intended" : { Reference(EvidenceVariable|Group) }, // Definition of the intended variable related to the Evidence
    "directnessMatch" : { CodeableConcept } // low | moderate | high | exact
  }],
  "synthesisType" : { CodeableConcept }, // The method to combine studies
  "studyDesign" : [{ CodeableConcept }], // The design of the study that produced this evidence
  "statistic" : [{ // Values and parameters for a single statistic
    "description" : "<markdown>", // Description of content
    "note" : [{ Annotation }], // Footnotes and/or explanatory notes
    "statisticType" : { CodeableConcept }, // Type of statistic, e.g., relative risk
    "category" : { CodeableConcept }, // Associated category for categorical variable
    "quantity" : { Quantity }, // Statistic value
    "numberOfEvents" : "<unsignedInt>", // The number of events associated with the statistic
    "numberAffected" : "<unsignedInt>", // The number of participants affected
    "sampleSize" : { // Number of samples in the statistic
      "description" : "<markdown>", // Textual description of sample size for statistic
      "note" : [{ Annotation }], // Footnote or explanatory note about the sample size
      "numberOfStudies" : "<unsignedInt>", // Number of contributing studies
      "numberOfParticipants" : "<unsignedInt>", // Cumulative number of participants
      "knownDataCount" : "<unsignedInt>" // Number of participants with known results for measured variables
    },
    "attributeEstimate" : [{ // An attribute of the Statistic
      "description" : "<markdown>", // Textual description of the attribute estimate
      "note" : [{ Annotation }], // Footnote or explanatory note about the estimate
      "type" : { CodeableConcept }, // The type of attribute estimate, e.g., confidence interval or p value
      "quantity" : { Quantity }, // The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure
      "level" : <decimal>, // Level of confidence interval, e.g., 0.95 for 95% confidence interval
      "range" : { Range }, // Lower and upper bound values of the attribute estimate
      "attributeEstimate" : [{ Content as for Evidence.statistic.attributeEstimate }] // A nested attribute estimate; which is the attribute estimate of an attribute estimate
    }],
    "modelCharacteristic" : [{ // An aspect of the statistical model
      "code" : { CodeableConcept }, // R!  Model specification
      "value" : { Quantity(SimpleQuantity) }, // Numerical value to complete model specification
      "variable" : [{ // A variable adjusted for in the adjusted analysis
        "variableDefinition" : { Reference(EvidenceVariable|Group) }, // R!  Description of the variable
        "handling" : "<code>", // continuous | dichotomous | ordinal | polychotomous
        "valueCategory" : [{ CodeableConcept }], // Description for grouping of ordinal or polychotomous variables
        "valueQuantity" : [{ Quantity }], // Discrete value for grouping of ordinal or polychotomous variables
        "valueRange" : [{ Range }] // Range of values for grouping of ordinal or polychotomous variables
      }],
      "attributeEstimate" : [{ Content as for Evidence.statistic.attributeEstimate }] // An attribute of the statistic used as a model characteristic
    }]
  }],
  "certainty" : [{ // Certainty or quality of the evidence
    "description" : "<markdown>", // Textual description of certainty
    "note" : [{ Annotation }], // Footnotes and/or explanatory notes
    "type" : { CodeableConcept }, // Aspect of certainty being rated
    "rating" : { CodeableConcept }, // Assessment or judgement of the aspect
    "rater" : "<string>", // Individual or group who did the rating
    "subcomponent" : [{ Content as for Evidence.certainty }] // A domain or subdomain of certainty
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:Evidence;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:url [ uri ] ; # 0..1 Canonical identifier for this evidence, represented as a globally unique URI
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Additional identifier for the summary
  fhir:version [ string ] ; # 0..1 Business version of this summary
  # versionAlgorithm[x] : 0..1 How to compare versions. One of these 2
    fhir:versionAlgorithm [  a fhir:string ; string ]
    fhir:versionAlgorithm [  a fhir:Coding ; Coding ]
  fhir:name [ string ] ; # 0..1 I Name for this summary (machine friendly)
  fhir:title [ string ] ; # 0..1 Name for this summary (human friendly)
  # citeAs[x] : 0..1 Citation for this evidence. One of these 2
    fhir:citeAs [  a fhir:Reference ; Reference(Citation) ]
    fhir:citeAs [  a fhir:markdown ; markdown ]
  fhir:status [ code ] ; # 1..1 draft | active | retired | unknown
  fhir:experimental [ boolean ] ; # 0..1 For testing purposes, not real usage
  fhir:date [ dateTime ] ; # 0..1 Date last changed
  fhir:approvalDate [ date ] ; # 0..1 When the summary was approved by publisher
  fhir:lastReviewDate [ date ] ; # 0..1 When the summary was last reviewed by the publisher
  fhir:publisher [ string ] ; # 0..1 Name of the publisher/steward (organization or individual)
  fhir:contact  ( [ ContactDetail ] ... ) ; # 0..* Contact details for the publisher
  fhir:author  ( [ ContactDetail ] ... ) ; # 0..* Who authored the content
  fhir:editor  ( [ ContactDetail ] ... ) ; # 0..* Who edited the content
  fhir:reviewer  ( [ ContactDetail ] ... ) ; # 0..* Who reviewed the content
  fhir:endorser  ( [ ContactDetail ] ... ) ; # 0..* Who endorsed the content
  fhir:useContext  ( [ UsageContext ] ... ) ; # 0..* The context that the content is intended to support
  fhir:purpose [ markdown ] ; # 0..1 Why this Evidence is defined
  fhir:copyright [ markdown ] ; # 0..1 Use and/or publishing restrictions
  fhir:copyrightLabel [ string ] ; # 0..1 Copyright holder and year(s)
  fhir:relatedArtifact  ( [ RelatedArtifact ] ... ) ; # 0..* Link or citation to artifact associated with the summary
  fhir:description [ markdown ] ; # 0..1 Description of the particular summary
  fhir:assertion [ markdown ] ; # 0..1 Declarative description of the Evidence
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
  fhir:variableDefinition ( [ # 1..* Evidence variable such as population, exposure, or outcome
    fhir:description [ markdown ] ; # 0..1 A text description or summary of the variable
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
    fhir:variableRole [ CodeableConcept ] ; # 1..1 population | subpopulation | exposure | referenceExposure | measuredVariable | confounder
    fhir:observed [ Reference(EvidenceVariable|Group) ] ; # 0..1 Definition of the actual variable related to the statistic(s)
    fhir:intended [ Reference(EvidenceVariable|Group) ] ; # 0..1 Definition of the intended variable related to the Evidence
    fhir:directnessMatch [ CodeableConcept ] ; # 0..1 low | moderate | high | exact
  ] ... ) ;
  fhir:synthesisType [ CodeableConcept ] ; # 0..1 The method to combine studies
  fhir:studyDesign  ( [ CodeableConcept ] ... ) ; # 0..* The design of the study that produced this evidence
  fhir:statistic ( [ # 0..* Values and parameters for a single statistic
    fhir:description [ markdown ] ; # 0..1 Description of content
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
    fhir:statisticType [ CodeableConcept ] ; # 0..1 Type of statistic, e.g., relative risk
    fhir:category [ CodeableConcept ] ; # 0..1 Associated category for categorical variable
    fhir:quantity [ Quantity ] ; # 0..1 Statistic value
    fhir:numberOfEvents [ unsignedInt ] ; # 0..1 The number of events associated with the statistic
    fhir:numberAffected [ unsignedInt ] ; # 0..1 The number of participants affected
    fhir:sampleSize [ # 0..1 Number of samples in the statistic
      fhir:description [ markdown ] ; # 0..1 Textual description of sample size for statistic
      fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnote or explanatory note about the sample size
      fhir:numberOfStudies [ unsignedInt ] ; # 0..1 Number of contributing studies
      fhir:numberOfParticipants [ unsignedInt ] ; # 0..1 Cumulative number of participants
      fhir:knownDataCount [ unsignedInt ] ; # 0..1 Number of participants with known results for measured variables
    ] ;
    fhir:attributeEstimate ( [ # 0..* An attribute of the Statistic
      fhir:description [ markdown ] ; # 0..1 Textual description of the attribute estimate
      fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnote or explanatory note about the estimate
      fhir:type [ CodeableConcept ] ; # 0..1 The type of attribute estimate, e.g., confidence interval or p value
      fhir:quantity [ Quantity ] ; # 0..1 The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure
      fhir:level [ decimal ] ; # 0..1 Level of confidence interval, e.g., 0.95 for 95% confidence interval
      fhir:range [ Range ] ; # 0..1 Lower and upper bound values of the attribute estimate
      fhir:attributeEstimate  ( [ See Evidence.statistic.attributeEstimate ] ... ) ; # 0..* A nested attribute estimate; which is the attribute estimate of an attribute estimate
    ] ... ) ;
    fhir:modelCharacteristic ( [ # 0..* An aspect of the statistical model
      fhir:code [ CodeableConcept ] ; # 1..1 Model specification
      fhir:value [ Quantity(SimpleQuantity) ] ; # 0..1 Numerical value to complete model specification
      fhir:variable ( [ # 0..* A variable adjusted for in the adjusted analysis
        fhir:variableDefinition [ Reference(EvidenceVariable|Group) ] ; # 1..1 Description of the variable
        fhir:handling [ code ] ; # 0..1 continuous | dichotomous | ordinal | polychotomous
        fhir:valueCategory  ( [ CodeableConcept ] ... ) ; # 0..* Description for grouping of ordinal or polychotomous variables
        fhir:valueQuantity  ( [ Quantity ] ... ) ; # 0..* Discrete value for grouping of ordinal or polychotomous variables
        fhir:valueRange  ( [ Range ] ... ) ; # 0..* Range of values for grouping of ordinal or polychotomous variables
      ] ... ) ;
      fhir:attributeEstimate  ( [ See Evidence.statistic.attributeEstimate ] ... ) ; # 0..* An attribute of the statistic used as a model characteristic
    ] ... ) ;
  ] ... ) ;
  fhir:certainty ( [ # 0..* Certainty or quality of the evidence
    fhir:description [ markdown ] ; # 0..1 Textual description of certainty
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
    fhir:type [ CodeableConcept ] ; # 0..1 Aspect of certainty being rated
    fhir:rating [ CodeableConcept ] ; # 0..1 Assessment or judgement of the aspect
    fhir:rater [ string ] ; # 0..1 Individual or group who did the rating
    fhir:subcomponent  ( [ See Evidence.certainty ] ... ) ; # 0..* A domain or subdomain of certainty
  ] ... ) ;
]

Changes since Release 4

Evidence

Evidence.versionAlgorithm[x]

Added Element

Evidence.citeAs[x]

Added Element

Evidence.experimental

Added Element

Evidence.purpose

Added Element

Evidence.copyrightLabel

Added Element

Evidence.assertion

Added Element

Evidence.variableDefinition

Added Mandatory Element

Evidence.variableDefinition.description

Added Element

Evidence.variableDefinition.note

Added Element

Evidence.variableDefinition.variableRole

Added Mandatory Element

Evidence.variableDefinition.observed

Added Element

Evidence.variableDefinition.intended

Added Element

Evidence.variableDefinition.directnessMatch

Added Element

Evidence.synthesisType

Added Element

Evidence.studyDesign

Added Element

Evidence.statistic

Added Element

Evidence.statistic.description

Added Element

Evidence.statistic.note

Added Element

Evidence.statistic.statisticType

Added Element

Evidence.statistic.category

Added Element

Evidence.statistic.quantity

Added Element

Evidence.statistic.numberOfEvents

Added Element

Evidence.statistic.numberAffected

Added Element

Evidence.statistic.sampleSize

Added Element

Evidence.statistic.sampleSize.description

Added Element

Evidence.statistic.sampleSize.note

Added Element

Evidence.statistic.sampleSize.numberOfStudies

Added Element

Evidence.statistic.sampleSize.numberOfParticipants

Added Element

Evidence.statistic.sampleSize.knownDataCount

Added Element

Evidence.statistic.attributeEstimate

Added Element

Evidence.statistic.attributeEstimate.description

Added Element

Evidence.statistic.attributeEstimate.note

Added Element

Evidence.statistic.attributeEstimate.type

Added Element

Evidence.statistic.attributeEstimate.quantity

Added Element

Evidence.statistic.attributeEstimate.level

Added Element

Evidence.statistic.attributeEstimate.range

Added Element

Evidence.statistic.attributeEstimate.attributeEstimate

Added Element

Evidence.statistic.modelCharacteristic

Added Element

Evidence.statistic.modelCharacteristic.code

Added Mandatory Element

Evidence.statistic.modelCharacteristic.value

Added Element

Evidence.statistic.modelCharacteristic.variable

Added Element

Evidence.statistic.modelCharacteristic.variable.variableDefinition

Added Mandatory Element

Evidence.statistic.modelCharacteristic.variable.handling

Added Element

Evidence.statistic.modelCharacteristic.variable.valueCategory

Added Element

Evidence.statistic.modelCharacteristic.variable.valueQuantity

Added Element

Evidence.statistic.modelCharacteristic.variable.valueRange

Added Element

Evidence.statistic.modelCharacteristic.attributeEstimate

Added Element

Evidence.certainty

Added Element

Evidence.certainty.description

Added Element

Evidence.certainty.note

Added Element

Evidence.certainty.type

Added Element

Evidence.certainty.rating

Added Element

Evidence.certainty.rater

Added Element

Evidence.certainty.subcomponent

Added Element

Evidence.shortTitle

deleted

Evidence.subtitle

deleted

Evidence.jurisdiction

deleted

Evidence.effectivePeriod

deleted

Evidence.topic

deleted

Evidence.exposureBackground

deleted

Evidence.exposureVariant

deleted

Evidence.outcome

deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

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

14.13.4.1 Terminology Bindings

Path	ValueSet	Type	Documentation
Evidence.versionAlgorithm[x]	VersionAlgorithm	Extensible	Indicates the mechanism used to compare versions to determine which is more current.
Evidence.status	PublicationStatus	Required	The lifecycle status of an artifact.
Evidence.variableDefinition.variableRole	EvidenceVariableRole	Extensible	The role that the assertion variable plays.
Evidence.variableDefinition.directnessMatch	EvidenceDirectness	Extensible	The quality of how direct the match is.
Evidence.synthesisType	SynthesisType	Extensible	Types of combining results from a body of evidence (e.g. summary data meta-analysis).
Evidence.studyDesign	StudyDesign	Extensible	This is a set of terms for study design characteristics.
Evidence.statistic.statisticType	StatisticType (a valid code from StatisticStatisticType )	Extensible	The type of a statistic, e.g. relative risk or mean
Evidence.statistic.attributeEstimate.type	AttributeEstimateType (a valid code from StatisticAttribute Estimate Type )	Extensible	A statistic about a statistic, e.g. Confidence interval or p-value
Evidence.statistic.modelCharacteristic.code	StatisticModelCode	Extensible	The handling of the variable in statistical analysis for exposures or outcomes.
Evidence.statistic.modelCharacteristic.variable.handling	EvidenceVariableHandling	Required	The handling of the variable in statistical analysis for exposures or outcomes (E.g. Dichotomous, Continuous, Descriptive).
Evidence.certainty.type	EvidenceCertaintyType	Extensible	The aspect of quality, confidence, or certainty.
Evidence.certainty.rating	EvidenceCertaintyRating	Extensible	The assessment of quality, confidence, or certainty.

Path

ValueSet

Type

Documentation

Evidence.versionAlgorithm[x]

VersionAlgorithm

Extensible

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

Evidence.status

PublicationStatus

Required

The lifecycle status of an artifact.

Evidence.variableDefinition.variableRole

EvidenceVariableRole

Extensible

The role that the assertion variable plays.

Evidence.variableDefinition.directnessMatch

EvidenceDirectness

Extensible

The quality of how direct the match is.

Evidence.synthesisType

SynthesisType

Extensible

Types of combining results from a body of evidence (e.g. summary data meta-analysis).

Evidence.studyDesign

StudyDesign

Extensible

This is a set of terms for study design characteristics.

Evidence.statistic.statisticType

StatisticType (a valid code from StatisticStatisticType icon

)

Extensible

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

Evidence.statistic.attributeEstimate.type

AttributeEstimateType (a valid code from StatisticAttribute Estimate Type icon

)

Extensible

A statistic about a statistic, e.g. Confidence interval or p-value

Evidence.statistic.modelCharacteristic.code

StatisticModelCode

Extensible

The handling of the variable in statistical analysis for exposures or outcomes.

Evidence.statistic.modelCharacteristic.variable.handling

EvidenceVariableHandling

Required

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

Evidence.certainty.type

EvidenceCertaintyType

Extensible

The aspect of quality, confidence, or certainty.

Evidence.certainty.rating

EvidenceCertaintyRating

Extensible

The assessment of quality, confidence, or certainty.

14.13.4.2 Constraints

UniqueKey

Level

Location

Description

Expression

cnl-0

Warning

(base)

Name should be usable as an identifier for the module by machine processing applications such as code generation

name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$')

cnl-1

Warning

Evidence.url

URL should not contain | or # - these characters make processing canonical references problematic

exists() implies matches('^[^|# ]+$')

14.13.5 Search Parameters

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

Name	Type	Description	Expression	In Common
context	token	A use context assigned to the evidence	(Evidence.useContext.value.ofType(CodeableConcept))	30 Resources
context-quantity	quantity	A quantity- or range-valued use context assigned to the evidence	(Evidence.useContext.value.ofType(Quantity)) \| (Evidence.useContext.value.ofType(Range))	30 Resources
context-type	token	A type of use context assigned to the evidence	Evidence.useContext.code	30 Resources
context-type-quantity	composite	A use context type and quantity- or range-based value assigned to the evidence	On Evidence.useContext: context-type: code context-quantity: value.ofType(Quantity) \| value.ofType(Range)	30 Resources
context-type-value	composite	A use context type and value assigned to the evidence	On Evidence.useContext: context-type: code context: value.ofType(CodeableConcept)	30 Resources
date	date	The evidence publication date	Evidence.date	30 Resources
description	string	The description of the evidence	Evidence.description	28 Resources
identifier	token	External identifier for the evidence	Evidence.identifier	33 Resources
publisher	string	Name of the publisher of the evidence	Evidence.publisher	30 Resources
status	token	The current status of the evidence	Evidence.status	34 Resources
title	string	The human-friendly name of the evidence	Evidence.title	27 Resources
url	uri	The uri that identifies the evidence	Evidence.url	33 Resources
version	token	The business version of the evidence	Evidence.version	30 Resources