Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot - ballot International flag

This page is part of the Evidence Based Medicine on FHIR Implementation Guide (v1.0.0-ballot: STU1 Ballot 1) based on FHIR (HL7® FHIR® Standard) v5.0.0. . For a full list of available versions, see the Directory of published versions

Resource Profile: RiskOfBias - Detailed Descriptions

Page standards status: Draft Maturity Level: 1

Definitions for the risk-of-bias resource profile.

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

0. ArtifactAssessment
2. ArtifactAssessment.extension
SlicingThis element introduces a set of slices on ArtifactAssessment.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
4. ArtifactAssessment.extension:url
Slice Nameurl
Control0..1
TypeExtension(Artifact URL) (Extension Type: uri)
6. ArtifactAssessment.extension:description
Slice Namedescription
Control0..1
TypeExtension(Artifact Description) (Extension Type: markdown)
8. ArtifactAssessment.extension:author
Slice Nameauthor
Control0..*
TypeExtension(Artifact Author) (Extension Type: ContactDetail)
10. ArtifactAssessment.identifier
Definition

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

ShortAdditional identifier for the RiskOfBias
Comments

Typically, this is used for identifiers that can be used in systems outside of FHIR, where it is not sufficient to use the logical URI.

NoteThis is a business identifier, not a resource identifier (see discussion)
Requirements

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

12. ArtifactAssessment.citeAs[x]
Definition

Display of or reference to the bibliographic citation of the RiskOfBias.

ShortHow to cite the RiskOfBias
[x] NoteSee Choice of Data Types for further information about how to use [x]
14. ArtifactAssessment.date
Definition

The date (and optionally time) when the RiskOfBias was published. The date should change when the substantive content of the RiskOfBias changes.

16. ArtifactAssessment.copyright
Definition

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

Requirements

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

18. ArtifactAssessment.approvalDate
ShortWhen the RiskOfBias was approved by publisher
20. ArtifactAssessment.lastReviewDate
ShortWhen the RiskOfBias was last reviewed
22. ArtifactAssessment.artifact[x]
Definition

A reference to a resource, canonical resource, or non-FHIR resource which the RiskOfBias is about.

ShortThe artifact that is rated
[x] NoteSee Choice of Data Types for further information about how to use [x]
SlicingThis element introduces a set of slices on ArtifactAssessment.artifact[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
24. ArtifactAssessment.artifact[x]:artifactReference
Slice NameartifactReference
Control0..1
TypeReference(Evidence, Composition, ResearchStudy, Citation)
[x] NoteSee Choice of Data Types for further information about how to use [x]
26. ArtifactAssessment.content
Definition

A rating or classification of the artifact.

ShortA rating
28. ArtifactAssessment.content.informationType
Comments

The code 'rating' will be the value in most instances. Other codes may be used for complex RiskOfBias with content.component use.

30. ArtifactAssessment.content.type
BindingUnless not suitable, these codes SHALL be taken from Risk Of Bias Type Value Set
32. ArtifactAssessment.content.classifier
BindingUnless not suitable, these codes SHALL be taken from EvidenceCertaintyRating
34. ArtifactAssessment.content.freeToShare
Definition

Acceptable to publicly share the RiskOfBias content, specific to the associated content instance

ShortAcceptable to publicly share the RiskOfBias content

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

0. ArtifactAssessment
Definition

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

ShortAdds metadata-supported comments, classifiers or ratings related to a Resource
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. ArtifactAssessment.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

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

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

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

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

An Extension


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

ShortExtensionAdditional content defined by implementations
Comments

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

Control0..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ArtifactAssessment.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
8. ArtifactAssessment.extension:url
Slice Nameurl
Definition

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

ShortCanonical identifier for this {{title}}, represented as a URI (globally unique)
Comments

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

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.

Control0..1
TypeExtension(Artifact URL) (Extension Type: uri)
Is Modifierfalse
Must Supportfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. ArtifactAssessment.extension:description
Slice Namedescription
Definition

A free text natural language description of the {{title}} from a consumer's perspective.

ShortNatural language description of the {{title}}
Comments

This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the {{title}} 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 {{title}} is presumed to be the predominant language in the place the {{title}} was created).

Control0..1
TypeExtension(Artifact Description) (Extension Type: markdown)
Is Modifierfalse
Must Supportfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. ArtifactAssessment.extension:author
Slice Nameauthor
Definition

An individiual or organization primarily involved in the creation and maintenance of the {{title}}.

ShortWho authored the {{title}}
Control0..*
TypeExtension(Artifact Author) (Extension Type: ContactDetail)
Is Modifierfalse
Must Supportfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. ArtifactAssessment.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

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

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Supportfalse
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. ArtifactAssessment.identifier
Definition

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


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

ShortAdditional identifier for the RiskOfBiasAdditional identifier for the artifact assessment
Comments

Typically, this is used for identifiers that can be used in systems outside of FHIR, where it is not sufficient to use the logical URI.


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

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

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


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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. ArtifactAssessment.citeAs[x]
Definition

Display of or reference to the bibliographic citation of the RiskOfBias.


Display of or reference to the bibliographic citation of the comment, classifier, or rating.

ShortHow to cite the RiskOfBiasHow to cite the comment or rating
Control0..1
TypeChoice of: Reference(Citation), markdown
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. ArtifactAssessment.date
Definition

The date (and optionally time) when the RiskOfBias was published. The date should change when the substantive content of the RiskOfBias changes.


The date (and optionally time) when the artifact assessment was published. The date must change when the disposition changes and it must change if the workflow status code changes. In addition, it should change when the substantive content of the artifact assessment changes.

ShortDate last changed
Comments

The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the artifact assessment. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

Control0..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Alternate NamesRevision Date
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. ArtifactAssessment.copyright
Definition

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


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

ShortUse and/or publishing restrictions
Control0..1
Typemarkdown
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Requirements

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


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

Alternate NamesLicense, Restrictions
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. ArtifactAssessment.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.

ShortWhen the RiskOfBias was approved by publisherWhen the artifact assessment was approved by publisher
Comments

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

Control0..1
Typedate
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. ArtifactAssessment.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.

ShortWhen the RiskOfBias was last reviewedWhen the artifact assessment was last reviewed by the publisher
Comments

If specified, this date follows the original approval date.

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. ArtifactAssessment.artifact[x]
Definition

A reference to a resource, canonical resource, or non-FHIR resource which the RiskOfBias is about.


A reference to a resource, canonical resource, or non-FHIR resource which the comment or assessment is about.

ShortThe artifact that is ratedThe artifact assessed, commented upon or rated
Control1..1
TypeChoice of: Reference(Resource), canonical, uri
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on ArtifactAssessment.artifact[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
30. ArtifactAssessment.artifact[x]:artifactReference
Slice NameartifactReference
Definition

A reference to a resource, canonical resource, or non-FHIR resource which the comment or assessment is about.

ShortThe artifact assessed, commented upon or rated
Control01..1
TypeReference(Evidence, Composition, ResearchStudy, Citation, Resource), canonical, uri
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. ArtifactAssessment.content
Definition

A rating or classification of the artifact.


A component comment, classifier, or rating of the artifact.

ShortA ratingComment, classifier, or rating content
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. ArtifactAssessment.content.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
36. ArtifactAssessment.content.informationType
Definition

The type of information this component of the content represents.

Shortcomment | classifier | rating | container | response | change-request
Comments

The code 'rating' will be the value in most instances. Other codes may be used for complex RiskOfBias with content.component use.

Control0..1
BindingThe codes SHALL be taken from ArtifactAssessmentInformationTypehttp://hl7.org/fhir/ValueSet/artifactassessment-information-type|5.0.0
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. ArtifactAssessment.content.type
Definition

Indicates what type of content this component represents.

ShortWhat type of content
Control0..1
BindingUnless not suitable, these codes SHALL be taken from For example codes, see Risk Of Bias Type Value Sethttp://hl7.org/fhir/ValueSet/certainty-type
TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. ArtifactAssessment.content.classifier
Definition

Represents a rating, classifier, or assessment of the artifact.

ShortRating, classifier, or assessment
Control0..*
BindingUnless not suitable, these codes SHALL be taken from For example codes, see EvidenceCertaintyRatinghttp://hl7.org/fhir/ValueSet/certainty-rating
TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. ArtifactAssessment.content.freeToShare
Definition

Acceptable to publicly share the RiskOfBias content, specific to the associated content instance


Acceptable to publicly share the comment, classifier or rating.

ShortAcceptable to publicly share the RiskOfBias contentAcceptable to publicly share the resource content
Control0..1
Typeboolean
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

0. ArtifactAssessment
Definition

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

ShortAdds metadata-supported comments, classifiers or ratings related to a Resource
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. ArtifactAssessment.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

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

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

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. ArtifactAssessment.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

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

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

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHALL be taken from AllLanguages

IETF language tag for a human language

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

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

ShortText summary of the resource, for human interpretation
Comments

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

Control0..1
This element is affected by the following invariants: dom-6
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. ArtifactAssessment.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

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

An Extension

ShortExtension
Control0..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ArtifactAssessment.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
16. ArtifactAssessment.extension:url
Slice Nameurl
Definition

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

ShortCanonical identifier for this {{title}}, represented as a URI (globally unique)
Comments

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

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.

Control0..1
TypeExtension(Artifact URL) (Extension Type: uri)
Is Modifierfalse
Must Supportfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. ArtifactAssessment.extension:description
Slice Namedescription
Definition

A free text natural language description of the {{title}} from a consumer's perspective.

ShortNatural language description of the {{title}}
Comments

This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the {{title}} 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 {{title}} is presumed to be the predominant language in the place the {{title}} was created).

Control0..1
TypeExtension(Artifact Description) (Extension Type: markdown)
Is Modifierfalse
Must Supportfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. ArtifactAssessment.extension:author
Slice Nameauthor
Definition

An individiual or organization primarily involved in the creation and maintenance of the {{title}}.

ShortWho authored the {{title}}
Control0..*
TypeExtension(Artifact Author) (Extension Type: ContactDetail)
Is Modifierfalse
Must Supportfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. ArtifactAssessment.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

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

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Supportfalse
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
24. ArtifactAssessment.identifier
Definition

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

ShortAdditional identifier for the RiskOfBias
Comments

Typically, this is used for identifiers that can be used in systems outside of FHIR, where it is not sufficient to use the logical URI.

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

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. ArtifactAssessment.title
Definition

A short title for the assessment for use in displaying and selecting.

ShortA short title for the assessment for use in displaying and selecting
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. ArtifactAssessment.citeAs[x]
Definition

Display of or reference to the bibliographic citation of the RiskOfBias.

ShortHow to cite the RiskOfBias
Control0..1
TypeChoice of: Reference(Citation), markdown
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. ArtifactAssessment.date
Definition

The date (and optionally time) when the RiskOfBias was published. The date should change when the substantive content of the RiskOfBias changes.

ShortDate last changed
Comments

The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the artifact assessment. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

Control0..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Alternate NamesRevision Date
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. ArtifactAssessment.copyright
Definition

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

ShortUse and/or publishing restrictions
Control0..1
Typemarkdown
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Requirements

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

Alternate NamesLicense, Restrictions
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. ArtifactAssessment.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.

ShortWhen the RiskOfBias was approved by publisher
Comments

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

Control0..1
Typedate
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. ArtifactAssessment.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.

ShortWhen the RiskOfBias was last reviewed
Comments

If specified, this date follows the original approval date.

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. ArtifactAssessment.artifact[x]
Definition

A reference to a resource, canonical resource, or non-FHIR resource which the RiskOfBias is about.

ShortThe artifact that is rated
Control1..1
TypeChoice of: Reference(Resource), canonical, uri
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on ArtifactAssessment.artifact[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
40. ArtifactAssessment.artifact[x]:artifactReference
Slice NameartifactReference
Definition

A reference to a resource, canonical resource, or non-FHIR resource which the comment or assessment is about.

ShortThe artifact assessed, commented upon or rated
Control0..1
TypeReference(Evidence, Composition, ResearchStudy, Citation)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. ArtifactAssessment.content
Definition

A rating or classification of the artifact.

ShortA rating
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. ArtifactAssessment.content.id
Definition

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

ShortUnique id for inter-element referencing
Control0..1
This element is affected by the following invariants: ele-1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
46. ArtifactAssessment.content.extension
Definition

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

ShortAdditional content defined by implementations
Comments

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

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
48. ArtifactAssessment.content.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
50. ArtifactAssessment.content.informationType
Definition

The type of information this component of the content represents.

Shortcomment | classifier | rating | container | response | change-request
Comments

The code 'rating' will be the value in most instances. Other codes may be used for complex RiskOfBias with content.component use.

Control0..1
BindingThe codes SHALL be taken from ArtifactAssessmentInformationType
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. ArtifactAssessment.content.summary
Definition

A brief summary of the content of this component.

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

Indicates what type of content this component represents.

ShortWhat type of content
Control0..1
BindingUnless not suitable, these codes SHALL be taken from Risk Of Bias Type Value Set
TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. ArtifactAssessment.content.classifier
Definition

Represents a rating, classifier, or assessment of the artifact.

ShortRating, classifier, or assessment
Control0..*
BindingUnless not suitable, these codes SHALL be taken from EvidenceCertaintyRating
TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. ArtifactAssessment.content.quantity
Definition

A quantitative rating of the artifact.

ShortQuantitative rating
Control0..1
TypeQuantity
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. ArtifactAssessment.content.author
Definition

Indicates who or what authored the content.

ShortWho authored the content
Control0..1
TypeReference(Patient, Practitioner, PractitionerRole, Organization, Device)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. ArtifactAssessment.content.path
Definition

A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource.

ShortWhat the comment is directed to
Comments

The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80).

Control0..*
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. ArtifactAssessment.content.relatedArtifact
Definition

Additional related artifacts that provide supporting documentation, additional evidence, or further information related to the content.

ShortAdditional information
Control0..*
TypeRelatedArtifact
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. ArtifactAssessment.content.freeToShare
Definition

Acceptable to publicly share the RiskOfBias content, specific to the associated content instance

ShortAcceptable to publicly share the RiskOfBias content
Control0..1
Typeboolean
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. ArtifactAssessment.content.component
Definition

If the informationType is container, the components of the content.

ShortContained content
Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. ArtifactAssessment.workflowStatus
Definition

Indicates the workflow status of the comment or change request.

Shortsubmitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published | entered-in-error
Control0..1
BindingThe codes SHALL be taken from ArtifactAssessmentWorkflowStatus
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. ArtifactAssessment.disposition
Definition

Indicates the disposition of the responsible party to the comment or change request.

Shortunresolved | not-persuasive | persuasive | persuasive-with-modification | not-persuasive-with-modification
Control0..1
BindingThe codes SHALL be taken from ArtifactAssessmentDisposition
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))