Release 4

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU) in it's permanent home (it will always be available at this URL). 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

Clinical Decision Support Work GroupMaturity Level: 0 Trial UseSecurity Category: Business Compartments: Not linked to any defined compartments

Detailed Descriptions for the elements in the Evidence resource.

Evidence
Element IdEvidence
Definition

The Evidence resource describes the conditional state (population and any exposures being compared within the population) and outcome (if specified) that the knowledge (evidence, assertion, recommendation) is about.

Cardinality0..*
TypeDomainResource
Invariants
Defined on this element
evi-0Warning Name should be usable as an identifier for the module by machine processing applications such as code generationname.matches('[A-Z]([A-Za-z0-9_]){0,254}')
Evidence.url
Element IdEvidence.url
Definition

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

Cardinality0..1
Typeuri
Requirements

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

Summarytrue
Comments

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

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

Evidence.identifier
Element IdEvidence.identifier
Definition

A formal identifier that is used to identify this evidence when it is represented in other formats, or referenced in a specification, model, design or an instance.

NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Requirements

Allows externally provided and/or usable business identifiers to be easily associated with the module.

Summarytrue
Comments

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this evidence outside of FHIR, where it is not possible to use the logical URI.

Evidence.version
Element IdEvidence.version
Definition

The identifier that is used to identify this version of the evidence when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the evidence author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts.

NoteThis is a business versionId, not a resource version id (see discussion)
Cardinality0..1
Typestring
Summarytrue
Comments

There may be different evidence instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the evidence with the format [url]|[version].

Evidence.name
Element IdEvidence.name
Definition

A natural language name identifying the evidence. This name should be usable as an identifier for the module by machine processing applications such as code generation.

Cardinality0..1
Typestring
Requirements

Support human navigation and code generation.

Summarytrue
Comments

The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

Invariants
Affect this element
inv-0Warning Name should be usable as an identifier for the module by machine processing applications such as code generationname.matches('[A-Z]([A-Za-z0-9_]){0,254}')
To DoNote: This was added back in because this is a metadata resource and it's a required element for metadata resource searching.
Evidence.title
Element IdEvidence.title
Definition

A short, descriptive, user-friendly title for the evidence.

Cardinality0..1
Typestring
Summarytrue
Comments

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

Evidence.shortTitle
Element IdEvidence.shortTitle
Definition

The short title provides an alternate title for use in informal descriptive contexts where the full, formal title is not necessary.

Cardinality0..1
Typestring
Requirements

Need to be able to reference the content by a short description, but still provide a longer, more formal title for the content.

Evidence.subtitle
Element IdEvidence.subtitle
Definition

An explanatory or alternate title for the Evidence giving additional information about its content.

Cardinality0..1
Typestring
Evidence.status
Element IdEvidence.status
Definition

The status of this evidence. Enables tracking the life-cycle of the content.

Cardinality1..1
Terminology BindingPublicationStatus (Required)
Typecode
Is Modifiertrue (Reason: This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration)
Summarytrue
Comments

Allows filtering of evidences that are appropriate for use versus not.

Evidence.date
Element IdEvidence.date
Definition

The date (and optionally time) when the evidence was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the evidence changes.

Cardinality0..1
TypedateTime
Alternate NamesRevision Date
Summarytrue
Comments

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the evidence. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

Evidence.publisher
Element IdEvidence.publisher
Definition

The name of the organization or individual that published the evidence.

Cardinality0..1
Typestring
Requirements

Helps establish the "authority/credibility" of the evidence. May also allow for contact.

Summarytrue
Comments

Usually an organization but may be an individual. The publisher (or steward) of the evidence is the organization or individual primarily responsible for the maintenance and upkeep of the evidence. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the evidence. This item SHOULD be populated unless the information is available from context.

Evidence.contact
Element IdEvidence.contact
Definition

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

Cardinality0..*
TypeContactDetail
Summarytrue
Comments

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

Evidence.description
Element IdEvidence.description
Definition

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

Cardinality0..1
Typemarkdown
Summarytrue
Comments

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

Evidence.note
Element IdEvidence.note
Definition

A human-readable string to clarify or explain concepts about the resource.

Cardinality0..*
TypeAnnotation
Evidence.useContext
Element IdEvidence.useContext
Definition

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

Cardinality0..*
TypeUsageContext
Requirements

Assist in searching for appropriate content.

Summarytrue
Comments

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

To DoNote: This was added back in because this is a metadata resource and it's a required element for metadata resource searching.
Evidence.jurisdiction
Element IdEvidence.jurisdiction
Definition

A legal or geographic region in which the evidence is intended to be used.

Cardinality0..*
Terminology BindingJurisdiction (Extensible)
TypeCodeableConcept
Summarytrue
Comments

It may be possible for the evidence to be used in jurisdictions other than those for which it was originally designed or intended.

To DoNote: This was added back in because this is a metadata resource and it's a required element for metadata resource searching.
Evidence.copyright
Element IdEvidence.copyright
Definition

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

Cardinality0..1
Typemarkdown
Requirements

Consumers must be able to determine any legal restrictions on the use of the evidence and/or its content.

Alternate NamesLicense; Restrictions
Evidence.approvalDate
Element IdEvidence.approvalDate
Definition

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

Cardinality0..1
Typedate
Comments

The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

To DoConsider how this applies to this resource.
Evidence.lastReviewDate
Element IdEvidence.lastReviewDate
Definition

The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

Cardinality0..1
Typedate
Requirements

Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

Comments

If specified, this date follows the original approval date.

To DoConsider how this applies to this resource.
Evidence.effectivePeriod
Element IdEvidence.effectivePeriod
Definition

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

Cardinality0..1
TypePeriod
Requirements

Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the evidence are or are expected to be used instead.

Summarytrue
Comments

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

To DoConsider how this applies to this resource.
Evidence.topic
Element IdEvidence.topic
Definition

Descriptive topics related to the content of the Evidence. Topics provide a high-level categorization grouping types of Evidences that can be useful for filtering and searching.

Cardinality0..*
Terminology BindingDefinitionTopic (Example)
TypeCodeableConcept
Requirements

Repositories must be able to determine how to categorize the Evidence so that it can be found by topical searches.

To DoConsider how this applies to this resource.
Evidence.author
Element IdEvidence.author
Definition

An individiual or organization primarily involved in the creation and maintenance of the content.

Cardinality0..*
TypeContactDetail
To DoConsider how this applies to this resource.
Evidence.editor
Element IdEvidence.editor
Definition

An individual or organization primarily responsible for internal coherence of the content.

Cardinality0..*
TypeContactDetail
To DoConsider how this applies to this resource.
Evidence.reviewer
Element IdEvidence.reviewer
Definition

An individual or organization primarily responsible for review of some aspect of the content.

Cardinality0..*
TypeContactDetail
To DoConsider how this applies to this resource.
Evidence.endorser
Element IdEvidence.endorser
Definition

An individual or organization responsible for officially endorsing the content for use in some setting.

Cardinality0..*
TypeContactDetail
To DoConsider how this applies to this resource.
Evidence.relatedArtifact
Element IdEvidence.relatedArtifact
Definition

Related artifacts such as additional documentation, justification, or bibliographic references.

Cardinality0..*
TypeRelatedArtifact
Requirements

Evidences must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

Comments

Each related artifact is either an attachment, or a reference to another resource, but not both.

To DoConsider how this applies to this resource.
Evidence.exposureBackground
Element IdEvidence.exposureBackground
Definition

A reference to a EvidenceVariable resource that defines the population for the research.

Cardinality1..1
TypeReference(EvidenceVariable)
Summarytrue
Evidence.exposureVariant
Element IdEvidence.exposureVariant
Definition

A reference to a EvidenceVariable resource that defines the exposure for the research.

Cardinality0..*
TypeReference(EvidenceVariable)
Summarytrue
Evidence.outcome
Element IdEvidence.outcome
Definition

A reference to a EvidenceVariable resomece that defines the outcome for the research.

Cardinality0..*
TypeReference(EvidenceVariable)
Summarytrue