R6 Ballot (1st Draft)
Clinical ReasoningThis page is part of the FHIR Specification v6.0.0-ballot1: Release 6 Ballot (1st Draft) (see Ballot Notes). The current version is 5.0.0. For a full list of available versions, see the Directory of published versions 
| Clinical Decision Support Work Group | Maturity Level: 1 | Trial Use | Security Category: Business | Compartments: No defined compartments |
The Citation Resource enables reference to any knowledge artifact for purposes of identification and attribution. The Citation Resource supports existing reference structures and developing publication practices such as versioning, expressing complex contributorship roles, and referencing computable resources.
The scope of the Citation Resource is to describe any aspect of identification, location, authorship, and contributorship to a journal article, report, document, resource, or other knowledge artifact. Citations are used extensively in scholarly communication and important for documenting the evidence or source behind statements of fact, opinion, and interpretation. Citations are also used for acknowledgement of the contributions of individuals and groups to the creation and advancement of knowledge.
Across the academic and scientific community citations are used extensively to reference the knowledge artifacts contributing to current work. For any community searching for reports of research or scholarly publications (such as searching MEDLINE) the citations contain the metadata used for such searches. Standardization of citations supports interoperability across citation managers and adaptation to current needs, such as reports being available on preprint servers before 'final' peer-reviewed published form, need to cite datasets or other alternative forms of expression, or the ability to support citation of FHIR Resources where the FHIR Resource represents research or scholarly publication.
Although citations as a concept are certainly not unique to healthcare, their use within healthcare contexts is ubiquitous, especially as part of the need to cite literature references and scientific knowledge as part of supporting evidence. This need is already manifest in references to the Citation resource from other FHIR resources including ResearchStudy, SubstanceDefinition, and DiagnosticReport. In addition, citations of evidence are a critical aspect of evidence-based medicine and structures to represent citation information are a necessary modeling component in the EBM-on-FHIR project. Without a resource dedicated to this concept, evidence-based medicine concepts and approaches would need to rely on extensions and/or non-FHIR-based solutions to exchange citation information, resulting in more complex and difficult to implement and maintain resource types to support evidence-based medicine.
The Resource can accommodate both human and machine readers. The summary element provides human-readable information.
The Citation Resource has multiple elements containing metadata that describe the citation resource itself, and a citedArtifact element containing metadata that describe the article or artifact being cited.
Attribution of scholarly contributions is expressed in the citedArtifact.contributorship element, which has grown more complex as the nature of authorship and the concerns for credit and acknowledgement are increasingly complex. If an individualized attribution structure is not required, the citedArtifact.contributorship.summary element will do.
"Publication" must now cover books, books series, article series, database registries, database updates, and the like. The element, citedArtifact.publicationForm, enables this description. Within citedArtifact.publicationForm, the publishedIn element identifies the largest container (journal, book, database, or newspaper), the periodicRelease element identifies the periodic issue, and the remaining elements (covering dates, language, and pagination) are specific to the artifact being cited.
Any resource may have common metadata including publisher, authors, reviewers, editors, endorsers, identifiers and location concepts for the resource. The Citation Resource is expected to be used primarily for citing things that are not FHIR Resources. There is NOT an expectation to provide Citations for most FHIR Resources. However, FHIR Resources can be the subject of Citation Resources when there is additional needs beyond common metadata to use the FHIR Resource as the cited source in other contexts or to support scholarly and scientific contribution attribution to the FHIR Resource content.
The Provenance Resource is used to track the contributions to a resource as it occurs, especially for purposes of confirming authenticity and trust. Citation.citedArtifact.contributorship is used to report the attribution of contributions to the cited artifact, especially for purposes of recognition and acknowledgement, but is not directly reporting the data to support authenticity of the contributions.
The DocumentReference Resource is described as a reference to a document of any kind for any purpose. As the DocumentReference Resource was developed for healthcare data exchange it is modeled to support individualized provenance, security, and artifact relationships as often needed in this context. The Citation Resource was developed for the reference to knowledge artifacts commonly used in scientific and scholarly communication so is modeled to support identification, attribution, classification, status tracking, and representation (summary) of the citation.
Approaches to a citation standard external to FHIR are not well suited for integration with FHIR-based approaches to Evidence and related resources. The MEDLINE citation format is widely used but not extensible for many types of knowledge artifacts that may be cited and not open to community development through open standards development methods. The RIS citation format is widely used but is not a singularly maintained standard and multiple implementations using RIS in different ways leads to confusion and inefficiency.
Structure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Citation | TU | DomainResource | A description of identification, location, or contributorship of a publication (article or artifact) + Warning: Name should be usable as an identifier for the module by machine processing applications such as code generation Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension Interfaces Implemented: MetadataResource | |
  url | ΣC | 0..1 | uri | Canonical identifier for this citation record, represented as a globally unique URI + Warning: URL should not contain | or # - these characters make processing canonical references problematic |
 identifier | Σ | 0..* | Identifier | Identifier for the citation record itself |
| version | Σ | 0..1 | string | Business version of the citation record |
  versionAlgorithm[x] | Σ | 0..1 | How to compare versions Binding: Version Algorithm (Extensible) | |
 versionAlgorithmString | string | |||
 versionAlgorithmCoding | Coding | |||
| name | ΣC | 0..1 | string | Name for this citation record (computer friendly) |
| title | ΣT | 0..1 | string | Name for this citation record (human friendly) |
| status | ?!Σ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (Required) |
| experimental | Σ | 0..1 | boolean | For testing purposes, not real usage |
| date | Σ | 0..1 | dateTime | Date last changed |
| publisher | ΣT | 0..1 | string | The publisher of the citation record, not the publisher of the article or artifact being cited |
| contact | Σ | 0..* | ContactDetail | Contact details for the publisher of the citation record |
| description | T | 0..1 | markdown | Natural language description of the citation |
| useContext | Σ | 0..* | UsageContext | The context that the citation record content is intended to support |
| jurisdiction | ΣXD | 0..* | CodeableConcept | Intended jurisdiction for citation record (if applicable) Binding: Jurisdiction ValueSet (Extensible) |
| purpose | T | 0..1 | markdown | Why this citation is defined |
| copyright | T | 0..1 | markdown | Use and/or publishing restrictions for the citation record, not for the cited artifact |
| copyrightLabel | T | 0..1 | string | Copyright holder and year(s) for the ciation record, not for the cited artifact |
| approvalDate | 0..1 | date | When the citation record was approved by publisher | |
| lastReviewDate | 0..1 | date | When the citation record was last reviewed by the publisher | |
| effectivePeriod | Σ | 0..1 | Period | When the citation record is expected to be used |
| author | 0..* | ContactDetail | Who authored the citation record | |
| editor | 0..* | ContactDetail | Who edited the citation record | |
| reviewer | 0..* | ContactDetail | Who reviewed the citation record | |
| endorser | 0..* | ContactDetail | Who endorsed the citation record | |
 summary | 0..* | BackboneElement | A human-readable display of key concepts to represent the citation | |
| style | 0..1 | CodeableConcept | Format for display of the citation summary Binding: Citation Summary Style (Extensible) | |
| text | Σ | 1..1 | markdown | The human-readable display of the citation summary |
| classification | 0..* | BackboneElement | The assignment to an organizing scheme | |
| type | 0..1 | CodeableConcept | The kind of classifier (e.g. publication type, keyword) Binding: Citation Classification Type (Extensible) | |
| classifier | 0..* | CodeableConcept | The specific classification value Binding: Citation Artifact Classifier (Example) | |
| note | 0..* | Annotation | Used for general notes and annotations not coded elsewhere | |
| currentState | 0..* | CodeableConcept | The status of the citation record Binding: Citation Status Type (Example) | |
| statusDate | 0..* | BackboneElement | An effective date or period for a status of the citation record | |
| activity | 1..1 | CodeableConcept | Classification of the status Binding: Citation Status Type (Example) | |
| actual | 0..1 | boolean | Either occurred or expected | |
| period | 1..1 | Period | When the status started and/or ended | |
| relatedArtifact | 0..* | RelatedArtifact | Artifact related to the citation record | |
 citedArtifact | 0..1 | BackboneElement | The article or artifact being described | |
 identifier | Σ | 0..* | Identifier | Unique identifier. May include DOI, PMID, PMCID, etc |
| relatedIdentifier | Σ | 0..* | Identifier | Identifier not unique to the cited artifact. May include trial registry identifiers |
| dateAccessed | Σ | 0..1 | dateTime | When the cited artifact was accessed |
| version | 0..1 | BackboneElement | The defined version of the cited artifact | |
| value | 1..1 | string | The version number or other version identifier | |
 baseCitation | 0..1 | Reference(Citation) | Citation for the main version of the cited artifact | |
| currentState | 0..* | CodeableConcept | The status of the cited artifact Binding: Cited Artifact Status Type (Extensible) | |
| statusDate | 0..* | BackboneElement | An effective date or period for a status of the cited artifact | |
| activity | 1..1 | CodeableConcept | Classification of the status Binding: Cited Artifact Status Type (Extensible) | |
| actual | 0..1 | boolean | Either occurred or expected | |
| period | 1..1 | Period | When the status started and/or ended | |
| title | 0..* | BackboneElement | The title details of the article or artifact | |
| type | 0..* | CodeableConcept | The kind of title Binding: Title Type (Extensible) | |
| language | 0..1 | CodeableConcept | Used to express the specific language Binding: Common Languages (Preferred) | |
| text | 1..1 | markdown | The title of the article or artifact | |
| abstract | 0..* | BackboneElement | Summary of the article or artifact | |
| type | 0..1 | CodeableConcept | The kind of abstract Binding: Cited Artifact Abstract Type (Extensible) | |
| language | 0..1 | CodeableConcept | Used to express the specific language Binding: Common Languages (Preferred) | |
| text | 1..1 | markdown | Abstract content | |
| copyright | 0..1 | markdown | Copyright notice for the abstract | |
| part | 0..1 | BackboneElement | The component of the article or artifact | |
| type | 0..1 | CodeableConcept | The kind of component Binding: Cited Artifact Part Type (Extensible) | |
| value | 0..1 | string | The specification of the component | |
| baseCitation | 0..1 | Reference(Citation) | The citation for the full article or artifact | |
| relatesTo | 0..* | BackboneElement | The artifact related to the cited artifact | |
| type | 1..1 | code | documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | documents | specification-of | created-with | cite-as | reprint | reprint-of Binding: Related Artifact Type All (Required) | |
| classifier | 0..* | CodeableConcept | Additional classifiers Binding: Citation Artifact Classifier (Extensible) | |
| label | 0..1 | string | Short label | |
| display | 0..1 | string | Brief description of the related artifact | |
| citation | 0..1 | markdown | Bibliographic citation for the artifact | |
| document | 0..1 | Attachment | What document is being referenced | |
| resource | 0..1 | canonical() | What artifact is being referenced | |
| resourceReference | 0..1 | Reference() | What artifact, if not a conformance resource | |
| publicationForm | 0..* | BackboneElement | If multiple, used to represent alternative forms of the article that are not separate citations | |
| publishedIn | 0..1 | BackboneElement | The collection the cited article or artifact is published in | |
| type | 0..1 | CodeableConcept | Kind of container (e.g. Periodical, database, or book) Binding: Published In Type (Extensible) | |
| identifier | 0..* | Identifier | Journal identifiers include ISSN, ISO Abbreviation and NLMuniqueID; Book identifiers include ISBN | |
| title | 0..1 | string | Name of the database or title of the book or journal | |
| publisher | 0..1 | Reference(Organization) | Name of or resource describing the publisher | |
| publisherLocation | 0..1 | string | Geographic location of the publisher | |
| citedMedium | 0..1 | CodeableConcept | Internet or Print Binding: Cited Medium (Extensible) | |
| volume | 0..1 | string | Volume number of journal or other collection in which the article is published | |
| issue | 0..1 | string | Issue, part or supplement of journal or other collection in which the article is published | |
| articleDate | 0..1 | dateTime | The date the article was added to the database, or the date the article was released | |
| publicationDateText | 0..1 | string | Text representation of the date on which the issue of the cited artifact was published | |
| publicationDateSeason | 0..1 | string | Season in which the cited artifact was published | |
| lastRevisionDate | 0..1 | dateTime | The date the article was last revised or updated in the database | |
| language | 0..* | CodeableConcept | Language(s) in which this form of the article is published Binding: Common Languages (Preferred) | |
| accessionNumber | 0..1 | string | Entry number or identifier for inclusion in a database | |
| pageString | 0..1 | string | Used for full display of pagination | |
| firstPage | 0..1 | string | Used for isolated representation of first page | |
| lastPage | 0..1 | string | Used for isolated representation of last page | |
| pageCount | 0..1 | string | Number of pages or screens | |
| copyright | 0..1 | markdown | Copyright notice for the full article or artifact | |
| webLocation | 0..* | BackboneElement | Used for any URL for the article or artifact cited | |
| classifier | 0..* | CodeableConcept | Code the reason for different URLs, e.g. abstract and full-text Binding: Artifact Url Classifier (Extensible) | |
| url | 0..1 | uri | The specific URL | |
| classification | 0..* | BackboneElement | The assignment to an organizing scheme | |
| type | 0..1 | CodeableConcept | The kind of classifier (e.g. publication type, keyword) Binding: Cited Artifact Classification Type (Extensible) | |
| classifier | 0..* | CodeableConcept | The specific classification value Binding: Citation Artifact Classifier (Example) | |
| artifactAssessment | 0..* | Reference(ArtifactAssessment) | Complex or externally created classification | |
| contributorship | 0..1 | BackboneElement | Attribution of authors and other contributors | |
| complete | 0..1 | boolean | Indicates if the list includes all authors and/or contributors | |
| entry | 0..* | BackboneElement | An individual entity named as a contributor | |
| contributor | 1..1 | Reference(Practitioner | Organization) | The identity of the individual contributor | |
| forenameInitials | 0..1 | string | For citation styles that use initials | |
| affiliation | 0..* | Reference(Organization | PractitionerRole) | Organizational affiliation | |
| contributionType | 0..* | CodeableConcept | The specific contribution Binding: Artifact Contribution Type (Extensible) | |
| role | 0..1 | CodeableConcept | The role of the contributor (e.g. author, editor, reviewer, funder) Binding: Contributor Role (Extensible) | |
| contributionInstance | 0..* | BackboneElement | Contributions with accounting for time or number | |
| type | 1..1 | CodeableConcept | The specific contribution Binding: Artifact Contribution Instance Type (Extensible) | |
| time | 0..1 | dateTime | The time that the contribution was made | |
| correspondingContact | 0..1 | boolean | Whether the contributor is the corresponding contributor for the role | |
| rankingOrder | 0..1 | positiveInt | Ranked order of contribution | |
| summary | 0..* | BackboneElement | Used to record a display of the author/contributor list without separate data element for each list member | |
| type | 0..1 | CodeableConcept | Such as author list, contributorship statement, funding statement, acknowledgements statement, or conflicts of interest statement Binding: Contributor Summary Type (Extensible) | |
| style | 0..1 | CodeableConcept | The format for the display string Binding: Contributor Summary Style (Extensible) | |
| source | 0..1 | CodeableConcept | Used to code the producer or rule for creating the display string Binding: Contributor Summary Source (Extensible) | |
| value | 1..1 | markdown | The display string for the author list, contributor list, or contributorship statement | |
| note | 0..* | Annotation | Any additional information or content for the article or artifact | |
| Documentation for this format | ||||
See the Extensions for this resource
UML Diagram (Legend)