Release 4B Ballot #1

This page is part of the FHIR Specification v4.1.0: R4B Ballot. About the R4B version of FHIR. The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

14.10 Resource Evidence - Content

Clinical Decision Support Work GroupMaturity Level: 1 Trial UseSecurity Category: Business Compartments: Not linked to any defined compartments

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

14.10.1 Scope and Usage

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

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

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

The heart of the evidence is the statistic. The Statistic DataType provides a machine-interpretable expression of a statistic, including the quantity; unit of measure; classification of statistic type; sample size; attributes such as confidence intervals, p values, and heterogeneity estimates; and statistic model characteristics. An Evidence resource may contain more than one statistic, in which case each statistic matches the same combination of variable definitions. The OrderedDistribution DataType provides a machine-interpretable expression of an ordered array of statistics, such as a histogram or a report stratified by quintiles.

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

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

14.10.2 Boundaries and Relationships

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

14.10.3 References

No resources refer to this resource directly.

This resource does not implement any patterns.

14.10.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Evidence TUDomainResourceSingle evidence bit
+ Warning: Name should be usable as an identifier for the module by machine processing applications such as code generation
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... url Σ0..1uriCanonical identifier for this evidence, represented as a globally unique URI
... identifier Σ0..*IdentifierAdditional identifier for the summary
... version Σ0..1stringBusiness version of this summary
... citeAs[x] 0..1Citation for this evidence
.... citeAsReferenceReference(Citation)
.... citeAsMarkdownmarkdown
... status ?!Σ1..1codedraft | active | retired | unknown
PublicationStatus (Required)
... date Σ0..1dateTimeDate last changed
... useContext Σ0..*UsageContextThe context that the content is intended to support
... approvalDate 0..1dateWhen the summary was approved by publisher
... lastReviewDate 0..1dateWhen the summary was last reviewed
... publisher Σ0..1stringName of the publisher (organization or individual)
... contact Σ0..*ContactDetailContact details for the publisher
... author Σ0..*ContactDetailWho authored the content
... editor 0..*ContactDetailWho edited the content
... reviewer 0..*ContactDetailWho reviewed the content
... endorser Σ0..*ContactDetailWho endorsed the content
... relatedArtifact 0..*RelatedArtifactLink or citation to artifact associated with the summary
... description 0..1markdownDescription of the particular summary
... assertion 0..1markdownDeclarative description of the Evidence
... note 0..*AnnotationFootnotes and/or explanatory notes
... variableDefinition 1..*BackboneElementEvidence variable such as population, exposure, or outcome
.... description 0..1markdownA text description or summary of the variable
.... note 0..*AnnotationFootnotes and/or explanatory notes
.... variableRole Σ1..1CodeableConceptpopulation | subpopulation | exposure | referenceExposure | measuredVariable | confounder
EvidenceVariableRole (Extensible)
.... observed Σ0..1Reference(Group | EvidenceVariable)Definition of the actual variable related to the statistic(s)
.... intended 0..1Reference(Group | EvidenceVariable)Definition of the intended variable related to the Evidence
.... directnessMatch 0..1CodeableConceptlow | moderate | high | exact
EvidenceDirectness (Extensible)
... synthesisType 0..1CodeableConceptThe method to combine studies
SynthesisType (Extensible)
... studyType 0..1CodeableConceptThe type of study that produced this evidence
StudyType (Extensible)
... statistic 0..*StatisticValues and parameters for a single statistic
... distribution 0..*OrderedDistributionAn ordered group of statistics
... certainty 0..*BackboneElementCertainty or quality of the evidence
.... description 0..1stringTextual description of certainty
.... note 0..*AnnotationFootnotes and/or explanatory notes
.... type 0..1CodeableConceptAspect of certainty being rated
EvidenceCertaintyType (Extensible)
.... rating 0..1CodeableConceptAssessment or judgement of the aspect
EvidenceCertaintyRating (Extensible)
.... rater 0..1stringIndividual or group who did the rating
.... subcomponent 0..*see certaintyA domain or subdomain of certainty

doco Documentation for this format

UML Diagram (Legend)

Evidence (DomainResource)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 summary is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the summary is stored on different serversurl : uri [0..1]A formal identifier that is used to identify this summary when it is represented in other formats, or referenced in a specification, model, design or an instanceidentifier : Identifier [0..*]The identifier that is used to identify this version of the summary when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the summary 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 sequenceversion : string [0..1]A short, descriptive, user-friendly title for the summarytitle : string [0..1]Citation Resource or display of suggested citation for this evidenceciteAs[x] : Element [0..1] « Reference(Citation)|markdown »The status of this summary. Enables tracking the life-cycle of the content (this element modifies the meaning of other elements)status : code [1..1] « null (Strength=Required)PublicationStatus! »The date (and optionally time) when the summary 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 summary changesdate : dateTime [0..1]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 instancesuseContext : UsageContext [0..*]The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usageapprovalDate : date [0..1]The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval datelastReviewDate : date [0..1]The name of the organization or individual that published the evidencepublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]An individiual, organization, or device primarily involved in the creation and maintenance of the contentauthor : ContactDetail [0..*]An individiual, organization, or device primarily responsible for internal coherence of the contenteditor : ContactDetail [0..*]An individiual, organization, or device primarily responsible for review of some aspect of the contentreviewer : ContactDetail [0..*]An individiual, organization, or device responsible for officially endorsing the content for use in some settingendorser : ContactDetail [0..*]Link or citation to artifact associated with the summaryrelatedArtifact : RelatedArtifact [0..*]A free text natural language description of the evidence from a consumer's perspectivedescription : markdown [0..1]Declarative description of the Evidenceassertion : markdown [0..1]Footnotes and/or explanatory notesnote : Annotation [0..*]The method to combine studiessynthesisType : CodeableConcept [0..1] « null (Strength=Extensible)SynthesisType+ »The type of study that produced this evidencestudyType : CodeableConcept [0..1] « null (Strength=Extensible)StudyType+ »Values and parameters for a single statisticstatistic : Statistic [0..*]An ordered group of statisticsdistribution : OrderedDistribution [0..*]VariableDefinitionA text description or summary of the variabledescription : markdown [0..1]Footnotes and/or explanatory notesnote : Annotation [0..*]population | subpopulation | exposure | referenceExposure | measuredVariable | confoundervariableRole : CodeableConcept [1..1] « null (Strength=Extensible)EvidenceVariableRole+ »Definition of the actual variable related to the statistic(s)observed : Reference [0..1] « Group|EvidenceVariable »Definition of the intended variable related to the Evidenceintended : Reference [0..1] « Group|EvidenceVariable »Indication of quality of match between intended variable to actual variabledirectnessMatch : CodeableConcept [0..1] « null (Strength=Extensible)EvidenceDirectness+ »CertaintyTextual description of certaintydescription : string [0..1]Footnotes and/or explanatory notesnote : Annotation [0..*]Aspect of certainty being ratedtype : CodeableConcept [0..1] « null (Strength=Extensible)EvidenceCertaintyType+ »Assessment or judgement of the aspectrating : CodeableConcept [0..1] « null (Strength=Extensible)EvidenceCertaintyRating+ »Individual or group who did the ratingrater : string [0..1]Evidence variable such as population, exposure, or outcomevariableDefinition[1..*]A domain or subdomain of certaintysubcomponent[0..*]Assessment of certainty, confidence in the estimates, or quality of the evidencecertainty[0..*]

XML Template

<Evidence xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Canonical identifier for this evidence, represented as a globally unique URI -->
 <identifier><!-- 0..* Identifier Additional identifier for the summary --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of this summary -->
 <title value="[string]"/><!-- 0..1 Name for this summary (human friendly) -->
 <citeAs[x]><!-- 0..1 Reference(Citation)|markdown Citation for this evidence --></citeAs[x]>
 <status value="[code]"/><!-- 1..1 draft | active | retired | unknown -->
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <approvalDate value="[date]"/><!-- 0..1 When the summary was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the summary was last reviewed -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <author><!-- 0..* ContactDetail Who authored the content --></author>
 <editor><!-- 0..* ContactDetail Who edited the content --></editor>
 <reviewer><!-- 0..* ContactDetail Who reviewed the content --></reviewer>
 <endorser><!-- 0..* ContactDetail Who endorsed the content --></endorser>
 <relatedArtifact><!-- 0..* RelatedArtifact Link or citation to artifact associated with the summary --></relatedArtifact>
 <description value="[markdown]"/><!-- 0..1 Description of the particular summary -->
 <assertion value="[markdown]"/><!-- 0..1 Declarative description of the Evidence -->
 <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
 <variableDefinition>  <!-- 1..* Evidence variable such as population, exposure, or outcome -->
  <description value="[markdown]"/><!-- 0..1 A text description or summary of the variable -->
  <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
  <variableRole><!-- 1..1 CodeableConcept population | subpopulation | exposure | referenceExposure | measuredVariable | confounder --></variableRole>
  <observed><!-- 0..1 Reference(EvidenceVariable|Group) Definition of the actual variable related to the statistic(s) --></observed>
  <intended><!-- 0..1 Reference(EvidenceVariable|Group) Definition of the intended variable related to the Evidence --></intended>
  <directnessMatch><!-- 0..1 CodeableConcept low | moderate | high | exact --></directnessMatch>
 </variableDefinition>
 <synthesisType><!-- 0..1 CodeableConcept The method to combine studies --></synthesisType>
 <studyType><!-- 0..1 CodeableConcept The type of study that produced this evidence --></studyType>
 <statistic><!-- 0..* Statistic Values and parameters for a single statistic --></statistic>
 <distribution><!-- 0..* OrderedDistribution An ordered group of statistics --></distribution>
 <certainty>  <!-- 0..* Certainty or quality of the evidence -->
  <description value="[string]"/><!-- 0..1 Textual description of certainty -->
  <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
  <type><!-- 0..1 CodeableConcept Aspect of certainty being rated --></type>
  <rating><!-- 0..1 CodeableConcept Assessment or judgement of the aspect --></rating>
  <rater value="[string]"/><!-- 0..1 Individual or group who did the rating -->
  <subcomponent><!-- 0..* Content as for Evidence.certainty A domain or subdomain of certainty --></subcomponent>
 </certainty>
</Evidence>

JSON Template

{doco
  "resourceType" : "Evidence",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Canonical identifier for this evidence, represented as a globally unique URI
  "identifier" : [{ Identifier }], // Additional identifier for the summary
  "version" : "<string>", // Business version of this summary
  "title" : "<string>", // Name for this summary (human friendly)
  // citeAs[x]: Citation for this evidence. One of these 2:
  "citeAsReference" : { Reference(Citation) },
  "citeAsMarkdown" : "<markdown>",
  "status" : "<code>", // R!  draft | active | retired | unknown
  "date" : "<dateTime>", // Date last changed
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "approvalDate" : "<date>", // When the summary was approved by publisher
  "lastReviewDate" : "<date>", // When the summary was last reviewed
  "publisher" : "<string>", // Name of the publisher (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "author" : [{ ContactDetail }], // Who authored the content
  "editor" : [{ ContactDetail }], // Who edited the content
  "reviewer" : [{ ContactDetail }], // Who reviewed the content
  "endorser" : [{ ContactDetail }], // Who endorsed the content
  "relatedArtifact" : [{ RelatedArtifact }], // Link or citation to artifact associated with the summary
  "description" : "<markdown>", // Description of the particular summary
  "assertion" : "<markdown>", // Declarative description of the Evidence
  "note" : [{ Annotation }], // Footnotes and/or explanatory notes
  "variableDefinition" : [{ // R!  Evidence variable such as population, exposure, or outcome
    "description" : "<markdown>", // A text description or summary of the variable
    "note" : [{ Annotation }], // Footnotes and/or explanatory notes
    "variableRole" : { CodeableConcept }, // R!  population | subpopulation | exposure | referenceExposure | measuredVariable | confounder
    "observed" : { Reference(EvidenceVariable|Group) }, // Definition of the actual variable related to the statistic(s)
    "intended" : { Reference(EvidenceVariable|Group) }, // Definition of the intended variable related to the Evidence
    "directnessMatch" : { CodeableConcept } // low | moderate | high | exact
  }],
  "synthesisType" : { CodeableConcept }, // The method to combine studies
  "studyType" : { CodeableConcept }, // The type of study that produced this evidence
  "statistic" : [{ Statistic }], // Values and parameters for a single statistic
  "distribution" : [{ OrderedDistribution }], // An ordered group of statistics
  "certainty" : [{ // Certainty or quality of the evidence
    "description" : "<string>", // Textual description of certainty
    "note" : [{ Annotation }], // Footnotes and/or explanatory notes
    "type" : { CodeableConcept }, // Aspect of certainty being rated
    "rating" : { CodeableConcept }, // Assessment or judgement of the aspect
    "rater" : "<string>", // Individual or group who did the rating
    "subcomponent" : [{ Content as for Evidence.certainty }] // A domain or subdomain of certainty
  }]
}

Turtle Template

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


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

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Evidence.url [ uri ]; # 0..1 Canonical identifier for this evidence, represented as a globally unique URI
  fhir:Evidence.identifier [ Identifier ], ... ; # 0..* Additional identifier for the summary
  fhir:Evidence.version [ string ]; # 0..1 Business version of this summary
  fhir:Evidence.title [ string ]; # 0..1 Name for this summary (human friendly)
  # Evidence.citeAs[x] : 0..1 Citation for this evidence. One of these 2
    fhir:Evidence.citeAsReference [ Reference(Citation) ]
    fhir:Evidence.citeAsMarkdown [ markdown ]
  fhir:Evidence.status [ code ]; # 1..1 draft | active | retired | unknown
  fhir:Evidence.date [ dateTime ]; # 0..1 Date last changed
  fhir:Evidence.useContext [ UsageContext ], ... ; # 0..* The context that the content is intended to support
  fhir:Evidence.approvalDate [ date ]; # 0..1 When the summary was approved by publisher
  fhir:Evidence.lastReviewDate [ date ]; # 0..1 When the summary was last reviewed
  fhir:Evidence.publisher [ string ]; # 0..1 Name of the publisher (organization or individual)
  fhir:Evidence.contact [ ContactDetail ], ... ; # 0..* Contact details for the publisher
  fhir:Evidence.author [ ContactDetail ], ... ; # 0..* Who authored the content
  fhir:Evidence.editor [ ContactDetail ], ... ; # 0..* Who edited the content
  fhir:Evidence.reviewer [ ContactDetail ], ... ; # 0..* Who reviewed the content
  fhir:Evidence.endorser [ ContactDetail ], ... ; # 0..* Who endorsed the content
  fhir:Evidence.relatedArtifact [ RelatedArtifact ], ... ; # 0..* Link or citation to artifact associated with the summary
  fhir:Evidence.description [ markdown ]; # 0..1 Description of the particular summary
  fhir:Evidence.assertion [ markdown ]; # 0..1 Declarative description of the Evidence
  fhir:Evidence.note [ Annotation ], ... ; # 0..* Footnotes and/or explanatory notes
  fhir:Evidence.variableDefinition [ # 1..* Evidence variable such as population, exposure, or outcome
    fhir:Evidence.variableDefinition.description [ markdown ]; # 0..1 A text description or summary of the variable
    fhir:Evidence.variableDefinition.note [ Annotation ], ... ; # 0..* Footnotes and/or explanatory notes
    fhir:Evidence.variableDefinition.variableRole [ CodeableConcept ]; # 1..1 population | subpopulation | exposure | referenceExposure | measuredVariable | confounder
    fhir:Evidence.variableDefinition.observed [ Reference(EvidenceVariable|Group) ]; # 0..1 Definition of the actual variable related to the statistic(s)
    fhir:Evidence.variableDefinition.intended [ Reference(EvidenceVariable|Group) ]; # 0..1 Definition of the intended variable related to the Evidence
    fhir:Evidence.variableDefinition.directnessMatch [ CodeableConcept ]; # 0..1 low | moderate | high | exact
  ], ...;
  fhir:Evidence.synthesisType [ CodeableConcept ]; # 0..1 The method to combine studies
  fhir:Evidence.studyType [ CodeableConcept ]; # 0..1 The type of study that produced this evidence
  fhir:Evidence.statistic [ Statistic ], ... ; # 0..* Values and parameters for a single statistic
  fhir:Evidence.distribution [ OrderedDistribution ], ... ; # 0..* An ordered group of statistics
  fhir:Evidence.certainty [ # 0..* Certainty or quality of the evidence
    fhir:Evidence.certainty.description [ string ]; # 0..1 Textual description of certainty
    fhir:Evidence.certainty.note [ Annotation ], ... ; # 0..* Footnotes and/or explanatory notes
    fhir:Evidence.certainty.type [ CodeableConcept ]; # 0..1 Aspect of certainty being rated
    fhir:Evidence.certainty.rating [ CodeableConcept ]; # 0..1 Assessment or judgement of the aspect
    fhir:Evidence.certainty.rater [ string ]; # 0..1 Individual or group who did the rating
    fhir:Evidence.certainty.subcomponent [ See Evidence.certainty ], ... ; # 0..* A domain or subdomain of certainty
  ], ...;
]

Changes since R3

Evidence
Evidence.citeAs[x]
  • Added Element
Evidence.status
  • Change value set from http://hl7.org/fhir/ValueSet/publication-status|4.0.0 to http://hl7.org/fhir/ValueSet/publication-status|4.1.0
Evidence.assertion
  • Added Element
Evidence.variableDefinition
  • Added Mandatory Element
Evidence.variableDefinition.description
  • Added Element
Evidence.variableDefinition.note
  • Added Element
Evidence.variableDefinition.variableRole
  • Added Mandatory Element
Evidence.variableDefinition.observed
  • Added Element
Evidence.variableDefinition.intended
  • Added Element
Evidence.variableDefinition.directnessMatch
  • Added Element
Evidence.synthesisType
  • Added Element
Evidence.studyType
  • Added Element
Evidence.statistic
  • Added Element
Evidence.distribution
  • Added Element
Evidence.certainty
  • Added Element
Evidence.certainty.description
  • Added Element
Evidence.certainty.note
  • Added Element
Evidence.certainty.type
  • Added Element
Evidence.certainty.rating
  • Added Element
Evidence.certainty.rater
  • Added Element
Evidence.certainty.subcomponent
  • Added Element
Evidence.name
  • deleted
Evidence.shortTitle
  • deleted
Evidence.subtitle
  • deleted
Evidence.jurisdiction
  • deleted
Evidence.copyright
  • deleted
Evidence.effectivePeriod
  • deleted
Evidence.topic
  • deleted
Evidence.exposureBackground
  • deleted
Evidence.exposureVariant
  • deleted
Evidence.outcome
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Evidence TUDomainResourceSingle evidence bit
+ Warning: Name should be usable as an identifier for the module by machine processing applications such as code generation
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... url Σ0..1uriCanonical identifier for this evidence, represented as a globally unique URI
... identifier Σ0..*IdentifierAdditional identifier for the summary
... version Σ0..1stringBusiness version of this summary
... citeAs[x] 0..1Citation for this evidence
.... citeAsReferenceReference(Citation)
.... citeAsMarkdownmarkdown
... status ?!Σ1..1codedraft | active | retired | unknown
PublicationStatus (Required)
... date Σ0..1dateTimeDate last changed
... useContext Σ0..*UsageContextThe context that the content is intended to support
... approvalDate 0..1dateWhen the summary was approved by publisher
... lastReviewDate 0..1dateWhen the summary was last reviewed
... publisher Σ0..1stringName of the publisher (organization or individual)
... contact Σ0..*ContactDetailContact details for the publisher
... author Σ0..*ContactDetailWho authored the content
... editor 0..*ContactDetailWho edited the content
... reviewer 0..*ContactDetailWho reviewed the content
... endorser Σ0..*ContactDetailWho endorsed the content
... relatedArtifact 0..*RelatedArtifactLink or citation to artifact associated with the summary
... description 0..1markdownDescription of the particular summary
... assertion 0..1markdownDeclarative description of the Evidence
... note 0..*AnnotationFootnotes and/or explanatory notes
... variableDefinition 1..*BackboneElementEvidence variable such as population, exposure, or outcome
.... description 0..1markdownA text description or summary of the variable
.... note 0..*AnnotationFootnotes and/or explanatory notes
.... variableRole Σ1..1CodeableConceptpopulation | subpopulation | exposure | referenceExposure | measuredVariable | confounder
EvidenceVariableRole (Extensible)
.... observed Σ0..1Reference(Group | EvidenceVariable)Definition of the actual variable related to the statistic(s)
.... intended 0..1Reference(Group | EvidenceVariable)Definition of the intended variable related to the Evidence
.... directnessMatch 0..1CodeableConceptlow | moderate | high | exact
EvidenceDirectness (Extensible)
... synthesisType 0..1CodeableConceptThe method to combine studies
SynthesisType (Extensible)
... studyType 0..1CodeableConceptThe type of study that produced this evidence
StudyType (Extensible)
... statistic 0..*StatisticValues and parameters for a single statistic
... distribution 0..*OrderedDistributionAn ordered group of statistics
... certainty 0..*BackboneElementCertainty or quality of the evidence
.... description 0..1stringTextual description of certainty
.... note 0..*AnnotationFootnotes and/or explanatory notes
.... type 0..1CodeableConceptAspect of certainty being rated
EvidenceCertaintyType (Extensible)
.... rating 0..1CodeableConceptAssessment or judgement of the aspect
EvidenceCertaintyRating (Extensible)
.... rater 0..1stringIndividual or group who did the rating
.... subcomponent 0..*see certaintyA domain or subdomain of certainty

doco Documentation for this format

UML Diagram (Legend)

Evidence (DomainResource)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 summary is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the summary is stored on different serversurl : uri [0..1]A formal identifier that is used to identify this summary when it is represented in other formats, or referenced in a specification, model, design or an instanceidentifier : Identifier [0..*]The identifier that is used to identify this version of the summary when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the summary 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 sequenceversion : string [0..1]A short, descriptive, user-friendly title for the summarytitle : string [0..1]Citation Resource or display of suggested citation for this evidenceciteAs[x] : Element [0..1] « Reference(Citation)|markdown »The status of this summary. Enables tracking the life-cycle of the content (this element modifies the meaning of other elements)status : code [1..1] « null (Strength=Required)PublicationStatus! »The date (and optionally time) when the summary 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 summary changesdate : dateTime [0..1]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 instancesuseContext : UsageContext [0..*]The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usageapprovalDate : date [0..1]The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval datelastReviewDate : date [0..1]The name of the organization or individual that published the evidencepublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]An individiual, organization, or device primarily involved in the creation and maintenance of the contentauthor : ContactDetail [0..*]An individiual, organization, or device primarily responsible for internal coherence of the contenteditor : ContactDetail [0..*]An individiual, organization, or device primarily responsible for review of some aspect of the contentreviewer : ContactDetail [0..*]An individiual, organization, or device responsible for officially endorsing the content for use in some settingendorser : ContactDetail [0..*]Link or citation to artifact associated with the summaryrelatedArtifact : RelatedArtifact [0..*]A free text natural language description of the evidence from a consumer's perspectivedescription : markdown [0..1]Declarative description of the Evidenceassertion : markdown [0..1]Footnotes and/or explanatory notesnote : Annotation [0..*]The method to combine studiessynthesisType : CodeableConcept [0..1] « null (Strength=Extensible)SynthesisType+ »The type of study that produced this evidencestudyType : CodeableConcept [0..1] « null (Strength=Extensible)StudyType+ »Values and parameters for a single statisticstatistic : Statistic [0..*]An ordered group of statisticsdistribution : OrderedDistribution [0..*]VariableDefinitionA text description or summary of the variabledescription : markdown [0..1]Footnotes and/or explanatory notesnote : Annotation [0..*]population | subpopulation | exposure | referenceExposure | measuredVariable | confoundervariableRole : CodeableConcept [1..1] « null (Strength=Extensible)EvidenceVariableRole+ »Definition of the actual variable related to the statistic(s)observed : Reference [0..1] « Group|EvidenceVariable »Definition of the intended variable related to the Evidenceintended : Reference [0..1] « Group|EvidenceVariable »Indication of quality of match between intended variable to actual variabledirectnessMatch : CodeableConcept [0..1] « null (Strength=Extensible)EvidenceDirectness+ »CertaintyTextual description of certaintydescription : string [0..1]Footnotes and/or explanatory notesnote : Annotation [0..*]Aspect of certainty being ratedtype : CodeableConcept [0..1] « null (Strength=Extensible)EvidenceCertaintyType+ »Assessment or judgement of the aspectrating : CodeableConcept [0..1] « null (Strength=Extensible)EvidenceCertaintyRating+ »Individual or group who did the ratingrater : string [0..1]Evidence variable such as population, exposure, or outcomevariableDefinition[1..*]A domain or subdomain of certaintysubcomponent[0..*]Assessment of certainty, confidence in the estimates, or quality of the evidencecertainty[0..*]

XML Template

<Evidence xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Canonical identifier for this evidence, represented as a globally unique URI -->
 <identifier><!-- 0..* Identifier Additional identifier for the summary --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of this summary -->
 <title value="[string]"/><!-- 0..1 Name for this summary (human friendly) -->
 <citeAs[x]><!-- 0..1 Reference(Citation)|markdown Citation for this evidence --></citeAs[x]>
 <status value="[code]"/><!-- 1..1 draft | active | retired | unknown -->
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <approvalDate value="[date]"/><!-- 0..1 When the summary was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the summary was last reviewed -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <author><!-- 0..* ContactDetail Who authored the content --></author>
 <editor><!-- 0..* ContactDetail Who edited the content --></editor>
 <reviewer><!-- 0..* ContactDetail Who reviewed the content --></reviewer>
 <endorser><!-- 0..* ContactDetail Who endorsed the content --></endorser>
 <relatedArtifact><!-- 0..* RelatedArtifact Link or citation to artifact associated with the summary --></relatedArtifact>
 <description value="[markdown]"/><!-- 0..1 Description of the particular summary -->
 <assertion value="[markdown]"/><!-- 0..1 Declarative description of the Evidence -->
 <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
 <variableDefinition>  <!-- 1..* Evidence variable such as population, exposure, or outcome -->
  <description value="[markdown]"/><!-- 0..1 A text description or summary of the variable -->
  <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
  <variableRole><!-- 1..1 CodeableConcept population | subpopulation | exposure | referenceExposure | measuredVariable | confounder --></variableRole>
  <observed><!-- 0..1 Reference(EvidenceVariable|Group) Definition of the actual variable related to the statistic(s) --></observed>
  <intended><!-- 0..1 Reference(EvidenceVariable|Group) Definition of the intended variable related to the Evidence --></intended>
  <directnessMatch><!-- 0..1 CodeableConcept low | moderate | high | exact --></directnessMatch>
 </variableDefinition>
 <synthesisType><!-- 0..1 CodeableConcept The method to combine studies --></synthesisType>
 <studyType><!-- 0..1 CodeableConcept The type of study that produced this evidence --></studyType>
 <statistic><!-- 0..* Statistic Values and parameters for a single statistic --></statistic>
 <distribution><!-- 0..* OrderedDistribution An ordered group of statistics --></distribution>
 <certainty>  <!-- 0..* Certainty or quality of the evidence -->
  <description value="[string]"/><!-- 0..1 Textual description of certainty -->
  <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
  <type><!-- 0..1 CodeableConcept Aspect of certainty being rated --></type>
  <rating><!-- 0..1 CodeableConcept Assessment or judgement of the aspect --></rating>
  <rater value="[string]"/><!-- 0..1 Individual or group who did the rating -->
  <subcomponent><!-- 0..* Content as for Evidence.certainty A domain or subdomain of certainty --></subcomponent>
 </certainty>
</Evidence>

JSON Template

{doco
  "resourceType" : "Evidence",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Canonical identifier for this evidence, represented as a globally unique URI
  "identifier" : [{ Identifier }], // Additional identifier for the summary
  "version" : "<string>", // Business version of this summary
  "title" : "<string>", // Name for this summary (human friendly)
  // citeAs[x]: Citation for this evidence. One of these 2:
  "citeAsReference" : { Reference(Citation) },
  "citeAsMarkdown" : "<markdown>",
  "status" : "<code>", // R!  draft | active | retired | unknown
  "date" : "<dateTime>", // Date last changed
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "approvalDate" : "<date>", // When the summary was approved by publisher
  "lastReviewDate" : "<date>", // When the summary was last reviewed
  "publisher" : "<string>", // Name of the publisher (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "author" : [{ ContactDetail }], // Who authored the content
  "editor" : [{ ContactDetail }], // Who edited the content
  "reviewer" : [{ ContactDetail }], // Who reviewed the content
  "endorser" : [{ ContactDetail }], // Who endorsed the content
  "relatedArtifact" : [{ RelatedArtifact }], // Link or citation to artifact associated with the summary
  "description" : "<markdown>", // Description of the particular summary
  "assertion" : "<markdown>", // Declarative description of the Evidence
  "note" : [{ Annotation }], // Footnotes and/or explanatory notes
  "variableDefinition" : [{ // R!  Evidence variable such as population, exposure, or outcome
    "description" : "<markdown>", // A text description or summary of the variable
    "note" : [{ Annotation }], // Footnotes and/or explanatory notes
    "variableRole" : { CodeableConcept }, // R!  population | subpopulation | exposure | referenceExposure | measuredVariable | confounder
    "observed" : { Reference(EvidenceVariable|Group) }, // Definition of the actual variable related to the statistic(s)
    "intended" : { Reference(EvidenceVariable|Group) }, // Definition of the intended variable related to the Evidence
    "directnessMatch" : { CodeableConcept } // low | moderate | high | exact
  }],
  "synthesisType" : { CodeableConcept }, // The method to combine studies
  "studyType" : { CodeableConcept }, // The type of study that produced this evidence
  "statistic" : [{ Statistic }], // Values and parameters for a single statistic
  "distribution" : [{ OrderedDistribution }], // An ordered group of statistics
  "certainty" : [{ // Certainty or quality of the evidence
    "description" : "<string>", // Textual description of certainty
    "note" : [{ Annotation }], // Footnotes and/or explanatory notes
    "type" : { CodeableConcept }, // Aspect of certainty being rated
    "rating" : { CodeableConcept }, // Assessment or judgement of the aspect
    "rater" : "<string>", // Individual or group who did the rating
    "subcomponent" : [{ Content as for Evidence.certainty }] // A domain or subdomain of certainty
  }]
}

Turtle Template

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


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

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Evidence.url [ uri ]; # 0..1 Canonical identifier for this evidence, represented as a globally unique URI
  fhir:Evidence.identifier [ Identifier ], ... ; # 0..* Additional identifier for the summary
  fhir:Evidence.version [ string ]; # 0..1 Business version of this summary
  fhir:Evidence.title [ string ]; # 0..1 Name for this summary (human friendly)
  # Evidence.citeAs[x] : 0..1 Citation for this evidence. One of these 2
    fhir:Evidence.citeAsReference [ Reference(Citation) ]
    fhir:Evidence.citeAsMarkdown [ markdown ]
  fhir:Evidence.status [ code ]; # 1..1 draft | active | retired | unknown
  fhir:Evidence.date [ dateTime ]; # 0..1 Date last changed
  fhir:Evidence.useContext [ UsageContext ], ... ; # 0..* The context that the content is intended to support
  fhir:Evidence.approvalDate [ date ]; # 0..1 When the summary was approved by publisher
  fhir:Evidence.lastReviewDate [ date ]; # 0..1 When the summary was last reviewed
  fhir:Evidence.publisher [ string ]; # 0..1 Name of the publisher (organization or individual)
  fhir:Evidence.contact [ ContactDetail ], ... ; # 0..* Contact details for the publisher
  fhir:Evidence.author [ ContactDetail ], ... ; # 0..* Who authored the content
  fhir:Evidence.editor [ ContactDetail ], ... ; # 0..* Who edited the content
  fhir:Evidence.reviewer [ ContactDetail ], ... ; # 0..* Who reviewed the content
  fhir:Evidence.endorser [ ContactDetail ], ... ; # 0..* Who endorsed the content
  fhir:Evidence.relatedArtifact [ RelatedArtifact ], ... ; # 0..* Link or citation to artifact associated with the summary
  fhir:Evidence.description [ markdown ]; # 0..1 Description of the particular summary
  fhir:Evidence.assertion [ markdown ]; # 0..1 Declarative description of the Evidence
  fhir:Evidence.note [ Annotation ], ... ; # 0..* Footnotes and/or explanatory notes
  fhir:Evidence.variableDefinition [ # 1..* Evidence variable such as population, exposure, or outcome
    fhir:Evidence.variableDefinition.description [ markdown ]; # 0..1 A text description or summary of the variable
    fhir:Evidence.variableDefinition.note [ Annotation ], ... ; # 0..* Footnotes and/or explanatory notes
    fhir:Evidence.variableDefinition.variableRole [ CodeableConcept ]; # 1..1 population | subpopulation | exposure | referenceExposure | measuredVariable | confounder
    fhir:Evidence.variableDefinition.observed [ Reference(EvidenceVariable|Group) ]; # 0..1 Definition of the actual variable related to the statistic(s)
    fhir:Evidence.variableDefinition.intended [ Reference(EvidenceVariable|Group) ]; # 0..1 Definition of the intended variable related to the Evidence
    fhir:Evidence.variableDefinition.directnessMatch [ CodeableConcept ]; # 0..1 low | moderate | high | exact
  ], ...;
  fhir:Evidence.synthesisType [ CodeableConcept ]; # 0..1 The method to combine studies
  fhir:Evidence.studyType [ CodeableConcept ]; # 0..1 The type of study that produced this evidence
  fhir:Evidence.statistic [ Statistic ], ... ; # 0..* Values and parameters for a single statistic
  fhir:Evidence.distribution [ OrderedDistribution ], ... ; # 0..* An ordered group of statistics
  fhir:Evidence.certainty [ # 0..* Certainty or quality of the evidence
    fhir:Evidence.certainty.description [ string ]; # 0..1 Textual description of certainty
    fhir:Evidence.certainty.note [ Annotation ], ... ; # 0..* Footnotes and/or explanatory notes
    fhir:Evidence.certainty.type [ CodeableConcept ]; # 0..1 Aspect of certainty being rated
    fhir:Evidence.certainty.rating [ CodeableConcept ]; # 0..1 Assessment or judgement of the aspect
    fhir:Evidence.certainty.rater [ string ]; # 0..1 Individual or group who did the rating
    fhir:Evidence.certainty.subcomponent [ See Evidence.certainty ], ... ; # 0..* A domain or subdomain of certainty
  ], ...;
]

Changes since Release 3

Evidence
Evidence.citeAs[x]
  • Added Element
Evidence.status
  • Change value set from http://hl7.org/fhir/ValueSet/publication-status|4.0.0 to http://hl7.org/fhir/ValueSet/publication-status|4.1.0
Evidence.assertion
  • Added Element
Evidence.variableDefinition
  • Added Mandatory Element
Evidence.variableDefinition.description
  • Added Element
Evidence.variableDefinition.note
  • Added Element
Evidence.variableDefinition.variableRole
  • Added Mandatory Element
Evidence.variableDefinition.observed
  • Added Element
Evidence.variableDefinition.intended
  • Added Element
Evidence.variableDefinition.directnessMatch
  • Added Element
Evidence.synthesisType
  • Added Element
Evidence.studyType
  • Added Element
Evidence.statistic
  • Added Element
Evidence.distribution
  • Added Element
Evidence.certainty
  • Added Element
Evidence.certainty.description
  • Added Element
Evidence.certainty.note
  • Added Element
Evidence.certainty.type
  • Added Element
Evidence.certainty.rating
  • Added Element
Evidence.certainty.rater
  • Added Element
Evidence.certainty.subcomponent
  • Added Element
Evidence.name
  • deleted
Evidence.shortTitle
  • deleted
Evidence.subtitle
  • deleted
Evidence.jurisdiction
  • deleted
Evidence.copyright
  • deleted
Evidence.effectivePeriod
  • deleted
Evidence.topic
  • deleted
Evidence.exposureBackground
  • deleted
Evidence.exposureVariant
  • deleted
Evidence.outcome
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

 

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the dependency analysis

14.10.4.1 Terminology Bindings

PathDefinitionTypeReference
Evidence.status RequiredPublicationStatus
Evidence.variableDefinition.variableRole ExtensibleEvidenceVariableRole
Evidence.variableDefinition.directnessMatch ExtensibleEvidenceDirectness
Evidence.synthesisType ExtensibleSynthesisType
Evidence.studyType ExtensibleStudyType
Evidence.certainty.type ExtensibleEvidenceCertaintyType
Evidence.certainty.rating ExtensibleEvidenceCertaintyRating

14.10.4.2 Constraints

idLevelLocationDescriptionExpression
cnl-0Warning (base)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}')

14.10.5 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionExpressionIn Common
contexttokenA use context assigned to the evidence(Evidence.useContext.value as CodeableConcept)
context-quantityquantityA quantity- or range-valued use context assigned to the evidence(Evidence.useContext.value as Quantity) | (Evidence.useContext.value as Range)
context-typetokenA type of use context assigned to the evidenceEvidence.useContext.code
context-type-quantitycompositeA use context type and quantity- or range-based value assigned to the evidenceOn Evidence.useContext:
  context-type: code
  context-quantity: value.as(Quantity) | value.as(Range)
context-type-valuecompositeA use context type and value assigned to the evidenceOn Evidence.useContext:
  context-type: code
  context: value.as(CodeableConcept)
date NdateThe evidence publication dateEvidence.date
description NstringThe description of the evidenceEvidence.description
identifiertokenExternal identifier for the evidenceEvidence.identifier
publisher NstringName of the publisher of the evidenceEvidence.publisher
status NtokenThe current status of the evidenceEvidence.status
title NstringThe human-friendly name of the evidenceEvidence.title
url NuriThe uri that identifies the evidenceEvidence.url
version NtokenThe business version of the evidenceEvidence.version