This page is part of the FHIR Specification v6.0.0-ballot1: Release 6 Ballot (1st Draft) (see Ballot Notes). The current version is 5.0.0. For a full list of available versions, see the Directory of published versions

14.8 Resource ArtifactAssessment - Content

Clinical Decision Support icon

Work Group

Maturity Level: 1

Trial Use

Security Category: Not Classified

Compartments: No defined compartments

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

14.8.1 Scope and Usage

The ArtifactAssessment Resource represents one or more assessments of another record or resource. The resource captures metadata about the assessment, as well as the data for the results of the assessment which might include comments, classifications, ratings, questions, and responses.

The ArtifactAssessment Resource provides a structure to communicate judgments or qualitative data about a record (a resource or other set of data with a known identity or URL by which it can be accessed), including comments, corrections, classifications, and ratings. The ArtifactAssessment Resource is used when the content attribution and management rights differ from the record being commented upon, or the commenter desires to separate the comments from the target record. The scope is intended to cover assessments (added information) regarding clinical records about individual human subjects, assessments (added information) regarding healthcare provision for individual persons (such as care plans), and assessments (added information) regarding records related to community knowledge such as scientific evidence and group-oriented guidance.

14.8.2 Boundaries and Relationships

ArtifactAssessment may by referenced by ArtifactAssessment and by Task.

ArtifactAssessment may reference any resource of 'community knowledge' and will likely reference Evidence, EvidenceVariable, EvidenceReport, PlanDefinition, ActivityDefinition, Library, Measure, and Citation. ArtifactAssessment may reference any resource of a 'medical record' and will likely reference DocumentReference, Composition, CarePlan, and DiagnosticReport.

ArtifactAssessment is about the content of a Resource and not about the provenance of the Resource so should not be confused with Provenance.

ArtifactAssessment is not used for communications that are not about a Resource so should not be confused with Communication or Composition (or profiles of Composition) which may be used for the primary communication about the subject matter.

Observation Resource is used extensively for observations about people, groups, devices, locations, substances, and procedures – not about the record describing these entities. ArtifiactAssessment is used for observations where the subject is the artifact or record, not the entity described by the artifact. Simple "assessments" about an Observation such as status, dataAbsentReason, interpretation and note would use the Observation Resource where this is already structured. ArtifactAssessment Resource may be used for complex assessments of an Observation such as justifications for reasons to correct the record.

14.8.3 Background and Context

Across healthcare communities, there are an extensive number of comments and corrections regarding resources where the commenter is not able or permitted to modify the resource content, and there are many situations in which assessments with classifications and ratings of medical record content are made by parties who would not include the assessments in the medical record. Across the academic, scientific, quality measurement development, and clinical decision support communities there is an extensive need to report assessments and feedback about resources and records. These artifact assessments may take multiple forms (including text, classifications, ratings or measurements) and might or might not be created, queried and maintained independently from the artifact being rated or commented upon.

14.8.4 References to this Resource

Resource References: Citation

Structure

Name	Flags	Card.	Type	Description & Constraints
ArtifactAssessment	TU		DomainResource	Adds metadata-supported comments, classifiers or ratings related to a Resource Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Additional identifier for the artifact assessment
title	Σ T	0..1	string	A short title for the assessment for use in displaying and selecting
citeAs[x]		0..1		How to cite the comment or rating
citeAsReference			Reference(Citation)
citeAsMarkdown			markdown
date	Σ	0..1	dateTime	Date last changed
copyright		0..1	markdown	Use and/or publishing restrictions
approvalDate		0..1	date	When the artifact assessment was approved by publisher
lastReviewDate	Σ	0..1	date	When the artifact assessment was last reviewed by the publisher
artifact[x]	Σ	1..1		The artifact assessed, commented upon or rated
artifactReference			Reference(Any)
artifactCanonical			canonical()
artifactUri			uri
content		0..*	BackboneElement	Comment, classifier, or rating content
informationType		0..1	code	comment \| classifier \| rating \| container \| response \| change-request Binding: Artifact Assessment Information Type (Required)
summary		0..1	markdown	Brief summary of the content
type		0..1	CodeableConcept	What type of content Binding: Evidence Certainty Type (Example)
classifier		0..*	CodeableConcept	Rating, classifier, or assessment Binding: Evidence Certainty Rating (Example)
quantity		0..1	Quantity	Quantitative rating
author		0..1	Reference(Patient \| Practitioner \| PractitionerRole \| Organization \| Device)	Who authored the content
path		0..*	uri	What the comment is directed to
relatedArtifact		0..*	RelatedArtifact	Additional information
freeToShare		0..1	boolean	Acceptable to publicly share the resource content
component		0..*	see content	Contained content
workflowStatus	Σ	0..1	code	submitted \| triaged \| waiting-for-input \| resolved-no-change \| resolved-change-required \| deferred \| duplicate \| applied \| published \| entered-in-error Binding: Artifact Assessment Workflow Status (Required)
disposition	Σ	0..1	code	unresolved \| not-persuasive \| persuasive \| persuasive-with-modification \| not-persuasive-with-modification Binding: Artifact Assessment Disposition (Required)
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<ArtifactAssessment xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Additional identifier for the artifact assessment --></identifier>
 <title value="[string]"/><!-- 0..1 A short title for the assessment for use in displaying and selecting -->
 <citeAs[x]><!-- 0..1 Reference(Citation)|markdown How to cite the comment or rating --></citeAs[x]>
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <approvalDate value="[date]"/><!-- 0..1 When the artifact assessment was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the artifact assessment was last reviewed by the publisher -->
 <artifact[x]><!-- 1..1 Reference(Any)|canonical|uri The artifact assessed, commented upon or rated --></artifact[x]>
 <content>  <!-- 0..* Comment, classifier, or rating content -->
  <informationType value="[code]"/><!-- 0..1 comment | classifier | rating | container | response | change-request -->
  <summary value="[markdown]"/><!-- 0..1 Brief summary of the content -->
  <type><!-- 0..1 CodeableConcept What type of content --></type>
  <classifier><!-- 0..* CodeableConcept Rating, classifier, or assessment --></classifier>
  <quantity><!-- 0..1 Quantity Quantitative rating --></quantity>
  <author><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
    PractitionerRole) Who authored the content --></author>
  <path value="[uri]"/><!-- 0..* What the comment is directed to -->
  <relatedArtifact><!-- 0..* RelatedArtifact Additional information --></relatedArtifact>
  <freeToShare value="[boolean]"/><!-- 0..1 Acceptable to publicly share the resource content -->
  <component><!-- 0..* Content as for ArtifactAssessment.content Contained content --></component>
 </content>
 <workflowStatus value="[code]"/><!-- 0..1 submitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published | entered-in-error -->
 <disposition value="[code]"/><!-- 0..1 unresolved | not-persuasive | persuasive | persuasive-with-modification | not-persuasive-with-modification -->
</ArtifactAssessment>

JSON Template

{
  "resourceType" : "ArtifactAssessment",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Additional identifier for the artifact assessment
  "title" : "<string>", // A short title for the assessment for use in displaying and selecting
  // citeAs[x]: How to cite the comment or rating. One of these 2:
  "citeAsReference" : { Reference(Citation) },
  "citeAsMarkdown" : "<markdown>",
  "date" : "<dateTime>", // Date last changed
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "approvalDate" : "<date>", // When the artifact assessment was approved by publisher
  "lastReviewDate" : "<date>", // When the artifact assessment was last reviewed by the publisher
  // artifact[x]: The artifact assessed, commented upon or rated. One of these 3:
  "artifactReference" : { Reference(Any) },
  "artifactCanonical" : "<canonical>",
  "artifactUri" : "<uri>",
  "content" : [{ // Comment, classifier, or rating content
    "informationType" : "<code>", // comment | classifier | rating | container | response | change-request
    "summary" : "<markdown>", // Brief summary of the content
    "type" : { CodeableConcept }, // What type of content
    "classifier" : [{ CodeableConcept }], // Rating, classifier, or assessment
    "quantity" : { Quantity }, // Quantitative rating
    "author" : { Reference(Device|Organization|Patient|Practitioner|
    PractitionerRole) }, // Who authored the content
    "path" : ["<uri>"], // What the comment is directed to
    "relatedArtifact" : [{ RelatedArtifact }], // Additional information
    "freeToShare" : <boolean>, // Acceptable to publicly share the resource content
    "component" : [{ Content as for ArtifactAssessment.content }] // Contained content
  }],
  "workflowStatus" : "<code>", // submitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published | entered-in-error
  "disposition" : "<code>" // unresolved | not-persuasive | persuasive | persuasive-with-modification | not-persuasive-with-modification
}

Turtle Template

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


[ a fhir:ArtifactAssessment;
  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:identifier  ( [ Identifier ] ... ) ; # 0..* Additional identifier for the artifact assessment
  fhir:title [ string ] ; # 0..1 A short title for the assessment for use in displaying and selecting
  # citeAs[x] : 0..1 How to cite the comment or rating. One of these 2
    fhir:citeAs [  a fhir:Reference ; Reference(Citation) ]
    fhir:citeAs [  a fhir:markdown ; markdown ]
  fhir:date [ dateTime ] ; # 0..1 Date last changed
  fhir:copyright [ markdown ] ; # 0..1 Use and/or publishing restrictions
  fhir:approvalDate [ date ] ; # 0..1 When the artifact assessment was approved by publisher
  fhir:lastReviewDate [ date ] ; # 0..1 When the artifact assessment was last reviewed by the publisher
  # artifact[x] : 1..1 The artifact assessed, commented upon or rated. One of these 3
    fhir:artifact [  a fhir:Reference ; Reference(Any) ]
    fhir:artifact [  a fhir:canonical ; canonical ]
    fhir:artifact [  a fhir:uri ; uri ]
  fhir:content ( [ # 0..* Comment, classifier, or rating content
    fhir:informationType [ code ] ; # 0..1 comment | classifier | rating | container | response | change-request
    fhir:summary [ markdown ] ; # 0..1 Brief summary of the content
    fhir:type [ CodeableConcept ] ; # 0..1 What type of content
    fhir:classifier  ( [ CodeableConcept ] ... ) ; # 0..* Rating, classifier, or assessment
    fhir:quantity [ Quantity ] ; # 0..1 Quantitative rating
    fhir:author [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole) ] ; # 0..1 Who authored the content
    fhir:path  ( [ uri ] ... ) ; # 0..* What the comment is directed to
    fhir:relatedArtifact  ( [ RelatedArtifact ] ... ) ; # 0..* Additional information
    fhir:freeToShare [ boolean ] ; # 0..1 Acceptable to publicly share the resource content
    fhir:component  ( [ See ArtifactAssessment.content ] ... ) ; # 0..* Contained content
  ] ... ) ;
  fhir:workflowStatus [ code ] ; # 0..1 submitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published | entered-in-error
  fhir:disposition [ code ] ; # 0..1 unresolved | not-persuasive | persuasive | persuasive-with-modification | not-persuasive-with-modification
]

Changes from both R4 and R4B

This resource did not exist in Release R4

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

Structure

Name	Flags	Card.	Type	Description & Constraints
ArtifactAssessment	TU		DomainResource	Adds metadata-supported comments, classifiers or ratings related to a Resource Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Additional identifier for the artifact assessment
title	Σ T	0..1	string	A short title for the assessment for use in displaying and selecting
citeAs[x]		0..1		How to cite the comment or rating
citeAsReference			Reference(Citation)
citeAsMarkdown			markdown
date	Σ	0..1	dateTime	Date last changed
copyright		0..1	markdown	Use and/or publishing restrictions
approvalDate		0..1	date	When the artifact assessment was approved by publisher
lastReviewDate	Σ	0..1	date	When the artifact assessment was last reviewed by the publisher
artifact[x]	Σ	1..1		The artifact assessed, commented upon or rated
artifactReference			Reference(Any)
artifactCanonical			canonical()
artifactUri			uri
content		0..*	BackboneElement	Comment, classifier, or rating content
informationType		0..1	code	comment \| classifier \| rating \| container \| response \| change-request Binding: Artifact Assessment Information Type (Required)
summary		0..1	markdown	Brief summary of the content
type		0..1	CodeableConcept	What type of content Binding: Evidence Certainty Type (Example)
classifier		0..*	CodeableConcept	Rating, classifier, or assessment Binding: Evidence Certainty Rating (Example)
quantity		0..1	Quantity	Quantitative rating
author		0..1	Reference(Patient \| Practitioner \| PractitionerRole \| Organization \| Device)	Who authored the content
path		0..*	uri	What the comment is directed to
relatedArtifact		0..*	RelatedArtifact	Additional information
freeToShare		0..1	boolean	Acceptable to publicly share the resource content
component		0..*	see content	Contained content
workflowStatus	Σ	0..1	code	submitted \| triaged \| waiting-for-input \| resolved-no-change \| resolved-change-required \| deferred \| duplicate \| applied \| published \| entered-in-error Binding: Artifact Assessment Workflow Status (Required)
disposition	Σ	0..1	code	unresolved \| not-persuasive \| persuasive \| persuasive-with-modification \| not-persuasive-with-modification Binding: Artifact Assessment Disposition (Required)
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<ArtifactAssessment xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Additional identifier for the artifact assessment --></identifier>
 <title value="[string]"/><!-- 0..1 A short title for the assessment for use in displaying and selecting -->
 <citeAs[x]><!-- 0..1 Reference(Citation)|markdown How to cite the comment or rating --></citeAs[x]>
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <approvalDate value="[date]"/><!-- 0..1 When the artifact assessment was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the artifact assessment was last reviewed by the publisher -->
 <artifact[x]><!-- 1..1 Reference(Any)|canonical|uri The artifact assessed, commented upon or rated --></artifact[x]>
 <content>  <!-- 0..* Comment, classifier, or rating content -->
  <informationType value="[code]"/><!-- 0..1 comment | classifier | rating | container | response | change-request -->
  <summary value="[markdown]"/><!-- 0..1 Brief summary of the content -->
  <type><!-- 0..1 CodeableConcept What type of content --></type>
  <classifier><!-- 0..* CodeableConcept Rating, classifier, or assessment --></classifier>
  <quantity><!-- 0..1 Quantity Quantitative rating --></quantity>
  <author><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
    PractitionerRole) Who authored the content --></author>
  <path value="[uri]"/><!-- 0..* What the comment is directed to -->
  <relatedArtifact><!-- 0..* RelatedArtifact Additional information --></relatedArtifact>
  <freeToShare value="[boolean]"/><!-- 0..1 Acceptable to publicly share the resource content -->
  <component><!-- 0..* Content as for ArtifactAssessment.content Contained content --></component>
 </content>
 <workflowStatus value="[code]"/><!-- 0..1 submitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published | entered-in-error -->
 <disposition value="[code]"/><!-- 0..1 unresolved | not-persuasive | persuasive | persuasive-with-modification | not-persuasive-with-modification -->
</ArtifactAssessment>

JSON Template

{
  "resourceType" : "ArtifactAssessment",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Additional identifier for the artifact assessment
  "title" : "<string>", // A short title for the assessment for use in displaying and selecting
  // citeAs[x]: How to cite the comment or rating. One of these 2:
  "citeAsReference" : { Reference(Citation) },
  "citeAsMarkdown" : "<markdown>",
  "date" : "<dateTime>", // Date last changed
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "approvalDate" : "<date>", // When the artifact assessment was approved by publisher
  "lastReviewDate" : "<date>", // When the artifact assessment was last reviewed by the publisher
  // artifact[x]: The artifact assessed, commented upon or rated. One of these 3:
  "artifactReference" : { Reference(Any) },
  "artifactCanonical" : "<canonical>",
  "artifactUri" : "<uri>",
  "content" : [{ // Comment, classifier, or rating content
    "informationType" : "<code>", // comment | classifier | rating | container | response | change-request
    "summary" : "<markdown>", // Brief summary of the content
    "type" : { CodeableConcept }, // What type of content
    "classifier" : [{ CodeableConcept }], // Rating, classifier, or assessment
    "quantity" : { Quantity }, // Quantitative rating
    "author" : { Reference(Device|Organization|Patient|Practitioner|
    PractitionerRole) }, // Who authored the content
    "path" : ["<uri>"], // What the comment is directed to
    "relatedArtifact" : [{ RelatedArtifact }], // Additional information
    "freeToShare" : <boolean>, // Acceptable to publicly share the resource content
    "component" : [{ Content as for ArtifactAssessment.content }] // Contained content
  }],
  "workflowStatus" : "<code>", // submitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published | entered-in-error
  "disposition" : "<code>" // unresolved | not-persuasive | persuasive | persuasive-with-modification | not-persuasive-with-modification
}

Turtle Template

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


[ a fhir:ArtifactAssessment;
  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:identifier  ( [ Identifier ] ... ) ; # 0..* Additional identifier for the artifact assessment
  fhir:title [ string ] ; # 0..1 A short title for the assessment for use in displaying and selecting
  # citeAs[x] : 0..1 How to cite the comment or rating. One of these 2
    fhir:citeAs [  a fhir:Reference ; Reference(Citation) ]
    fhir:citeAs [  a fhir:markdown ; markdown ]
  fhir:date [ dateTime ] ; # 0..1 Date last changed
  fhir:copyright [ markdown ] ; # 0..1 Use and/or publishing restrictions
  fhir:approvalDate [ date ] ; # 0..1 When the artifact assessment was approved by publisher
  fhir:lastReviewDate [ date ] ; # 0..1 When the artifact assessment was last reviewed by the publisher
  # artifact[x] : 1..1 The artifact assessed, commented upon or rated. One of these 3
    fhir:artifact [  a fhir:Reference ; Reference(Any) ]
    fhir:artifact [  a fhir:canonical ; canonical ]
    fhir:artifact [  a fhir:uri ; uri ]
  fhir:content ( [ # 0..* Comment, classifier, or rating content
    fhir:informationType [ code ] ; # 0..1 comment | classifier | rating | container | response | change-request
    fhir:summary [ markdown ] ; # 0..1 Brief summary of the content
    fhir:type [ CodeableConcept ] ; # 0..1 What type of content
    fhir:classifier  ( [ CodeableConcept ] ... ) ; # 0..* Rating, classifier, or assessment
    fhir:quantity [ Quantity ] ; # 0..1 Quantitative rating
    fhir:author [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole) ] ; # 0..1 Who authored the content
    fhir:path  ( [ uri ] ... ) ; # 0..* What the comment is directed to
    fhir:relatedArtifact  ( [ RelatedArtifact ] ... ) ; # 0..* Additional information
    fhir:freeToShare [ boolean ] ; # 0..1 Acceptable to publicly share the resource content
    fhir:component  ( [ See ArtifactAssessment.content ] ... ) ; # 0..* Contained content
  ] ... ) ;
  fhir:workflowStatus [ code ] ; # 0..1 submitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published | entered-in-error
  fhir:disposition [ code ] ; # 0..1 unresolved | not-persuasive | persuasive | persuasive-with-modification | not-persuasive-with-modification
]

Changes from both R4 and R4B

This resource did not exist in Release R4

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

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

14.8.5.1 Terminology Bindings

Path	ValueSet	Type	Documentation
ArtifactAssessment.content.informationType	ArtifactAssessmentInformationType	Required	The type of information contained in a component of an artifact assessment.
ArtifactAssessment.content.type	EvidenceCertaintyType	Example	The aspect of quality, confidence, or certainty.
ArtifactAssessment.content.classifier	EvidenceCertaintyRating	Example	The assessment of quality, confidence, or certainty.
ArtifactAssessment.workflowStatus	ArtifactAssessmentWorkflowStatus	Required	Possible values for the workflow status of the comment or assessment, typically used to coordinate workflow around the process of accepting and rejecting changes and comments on the artifact.
ArtifactAssessment.disposition	ArtifactAssessmentDisposition	Required	Possible values for the disposition of a comment or change request, typically used for comments and change requests, to indicate the disposition of the responsible party towards the changes suggested by the comment or change request.

Path

ValueSet

Type

Documentation

ArtifactAssessment.content.informationType

ArtifactAssessmentInformationType

Required

The type of information contained in a component of an artifact assessment.

ArtifactAssessment.content.type

EvidenceCertaintyType

Example

The aspect of quality, confidence, or certainty.

ArtifactAssessment.content.classifier

EvidenceCertaintyRating

Example

The assessment of quality, confidence, or certainty.

ArtifactAssessment.workflowStatus

ArtifactAssessmentWorkflowStatus

Required

Possible values for the workflow status of the comment or assessment, typically used to coordinate workflow around the process of accepting and rejecting changes and comments on the artifact.

ArtifactAssessment.disposition

ArtifactAssessmentDisposition

Required

Possible values for the disposition of a comment or change request, typically used for comments and change requests, to indicate the disposition of the responsible party towards the changes suggested by the comment or change request.

14.8.6 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
date	date	The artifact assessment publication date	ArtifactAssessment.date
identifier	token	The artifact assessment identifier	ArtifactAssessment.identifier