Release 4 R5 Final QA

This page is part of the FHIR Specification (v4.0.1: R4 (v5.0.0-draft-final: Final QA Preview for R5 - Mixed Normative and STU see ballot notes ) in it's permanent home (it will always be available at this URL). ). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 Content Examples Detailed Descriptions Mappings Profiles & Extensions 14.9 Resource Evidence - Content R3

Example CodeSystem/resource-validation-mode (JSON)

Clinical Decision Support FHIR Infrastructure Work Group Maturity Level : 0   Trial Use N/A Security Category Standards Status : Business Informative Compartments : Not linked to any defined compartments
The Evidence resource describes the conditional state (population and any exposures being compared within the population) and outcome (if specified) that the knowledge (evidence, assertion, recommendation) is about. 14.9.1 Scope and Usage The scope of the Evidence resource is to describe the conditional state (population and exposures being considered or compared within a population) with or without the outcomes that knowledge (evidence, assertion, recommendation) is about. The Evidence resource is a commonly bundled series of evidence variables from the "PICO" specification of medical knowledge: Population - the population within which exposures and outcomes are being considered Intervention - the conditional state or exposure state being described for which one is expressing the risk of or effect on an outcome Comparison - the alternative conditional state or alternative exposure state when one is comparing states for the effect on an outcome Outcome - the result or effect of an intervention or exposure in a population PICO (and its variants like PECO or PICOT) is a universal acronym used in evidence-based medicine communities to clearly express research questions and evidence findings. The Evidence resource allows expression of the higher-order concept for recommendations in healthcare where multiple outcomes are considered, and the higher-order concept/combination for framing research questions. 14.9.2 Boundaries and Relationships The Evidence resource references the EvidenceVariable resource two or more times to clearly specify the relationship among evidence variable concepts in framing a research question, evidence assertion, or recommendation. 14.9.3 Resource Content Structure Name Flags Card. Type Description & Constraints Evidence I TU DomainResource A research context or question + 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 Σ 0..1 uri Canonical identifier for this evidence, represented as a URI (globally unique) identifier Σ 0..* Identifier Additional identifier for the evidence version Σ 0..1 string Business version of the evidence name Σ I 0..1 string Name for this evidence (computer friendly) title Σ 0..1 string Name for this evidence (human friendly) shortTitle 0..1 string Title for use in informal contexts subtitle 0..1 string Subordinate title of the Evidence status ?! Σ 1..1 code draft | active | retired | unknown PublicationStatus ( Required ) date Σ 0..1 dateTime Date last changed publisher Σ 0..1 string Name of the publisher (organization or individual) contact Σ 0..* ContactDetail Contact details for the publisher description Σ 0..1 markdown Natural language description of the evidence note 0..* Annotation Used for footnotes or explanatory notes useContext Σ 0..* UsageContext The context that the content is intended to support jurisdiction Σ 0..* CodeableConcept Intended jurisdiction for evidence (if applicable) Jurisdiction ( Extensible ) copyright 0..1 markdown Use and/or publishing restrictions approvalDate 0..1 date When the evidence was approved by publisher lastReviewDate 0..1 date When the evidence was last reviewed effectivePeriod Σ 0..1 Period When the evidence is expected to be used topic 0..* CodeableConcept The category of the Evidence, such as Education, Treatment, Assessment, etc. DefinitionTopic ( Example ) author 0..* ContactDetail Who authored the content editor 0..* ContactDetail Who edited the content reviewer 0..* ContactDetail Who reviewed the content endorser 0..* ContactDetail Who endorsed the content relatedArtifact 0..* RelatedArtifact Additional documentation, citations, etc. exposureBackground Σ 1..1 Reference ( EvidenceVariable ) What population? exposureVariant Σ 0..* Reference ( EvidenceVariable ) What exposure? outcome Σ 0..* Reference ( EvidenceVariable ) What outcome? Documentation for this format

UML Diagram ( Legend Raw JSON ) 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 evidence is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the evidence is stored on different servers url : uri [0..1] A formal identifier that is used to identify this evidence when it is represented in other formats, or referenced in a specification, model, design or an instance identifier : Identifier [0..*] The identifier that is used to identify this version of the evidence when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the evidence author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts version : string [0..1] A natural language name identifying the evidence. This name should be usable as an identifier for the module by machine processing applications such as code generation name : string [0..1] A short, descriptive, user-friendly title for the evidence title : string [0..1] The short title provides an alternate title for use in informal descriptive contexts where the full, formal title is not necessary shortTitle : string [0..1] An explanatory or alternate title for the Evidence giving additional information about its content subtitle : string [0..1] The status of this evidence. Enables tracking the life-cycle of the content (this element modifies the meaning of other elements) status : code [1..1] « The lifecycle status of an artifact. (Strength=Required) PublicationStatus ! » The date (and optionally time) when the evidence was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the evidence changes date : dateTime [0..1] The name of the organization or individual that published the evidence publisher : string [0..1] Contact details to assist a user in finding and communicating with the publisher contact : ContactDetail [0..*] A free text natural language description of the evidence from a consumer's perspective description : markdown [0..1] A human-readable string to clarify or explain concepts about the resource note : Annotation [0..*] The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate evidence instances useContext : UsageContext [0..*] A legal or geographic region in which the evidence is intended to be used jurisdiction : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use. (Strength=Extensible) Jurisdiction ValueSet form + » A copyright statement relating to the evidence and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the evidence copyright : markdown [0..1] The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage approvalDate : 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 date lastReviewDate : date [0..1] The period during which the evidence content was or is planned to be in active use effectivePeriod : Period [0..1] Descriptive topics related to the content of the Evidence. Topics provide a high-level categorization grouping types of Evidences that can be useful for filtering and searching topic : CodeableConcept [0..*] « High-level categorization of the definition, used for searching, sorting, and filtering. (Strength=Example) DefinitionTopic ?? » An individiual or organization primarily involved in the creation and maintenance of the content author : ContactDetail [0..*] An individual or organization primarily responsible for internal coherence of the content editor : ContactDetail [0..*] An individual or organization primarily responsible for review of some aspect of the content reviewer : ContactDetail [0..*] An individual or organization responsible for officially endorsing the content for use in some setting endorser : ContactDetail [0..*] Related artifacts such as additional documentation, justification, or bibliographic references relatedArtifact : RelatedArtifact [0..*] A reference to a EvidenceVariable resource that defines the population for the research exposureBackground : Reference [1..1] « EvidenceVariable » A reference to a EvidenceVariable resource that defines the exposure for the research exposureVariant : Reference [0..*] « EvidenceVariable » A reference to a EvidenceVariable resomece that defines the outcome for the research outcome : Reference [0..*] « EvidenceVariable also see JSON Format Specification » XML Template )

< <!-- from --> <!-- from --> < <</identifier> < < < < < < < < <</contact> < <</note> <</useContext> <</jurisdiction> < < < <</effectivePeriod> <</topic> <</author> <</editor> <</reviewer> <</endorser> <</relatedArtifact> <</exposureBackground> <</exposureVariant> <</outcome> </Evidence>

JSON Template Definition for Code SystemResourceValidationMode

{ "resourceType" : "", // from // from " " " " " " " " " " " " " " " " " " " " " " " " " " " "
{
  "resourceType" : "CodeSystem",
  "id" : "resource-validation-mode",
  "meta" : {
    "lastUpdated" : "2023-03-01T23:03:57.298+11:00",
    "profile" : ["http://hl7.org/fhir/StructureDefinition/shareablecodesystem"]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This code system <code>http://hl7.org/fhir/resource-validation-mode</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">create<a name=\"resource-validation-mode-create\"> </a></td><td>Validate for Create</td><td>The server checks the content, and then checks that the content would be acceptable as a create (e.g. that the content would not violate any uniqueness constraints).</td></tr><tr><td style=\"white-space:nowrap\">update<a name=\"resource-validation-mode-update\"> </a></td><td>Validate for Update</td><td>The server checks the content, and then checks that it would accept it as an update against the nominated specific resource (e.g. that there are no changes to immutable fields the server does not allow to change and checking version integrity if appropriate).</td></tr><tr><td style=\"white-space:nowrap\">delete<a name=\"resource-validation-mode-delete\"> </a></td><td>Validate for Delete</td><td>The server ignores the content and checks that the nominated resource is allowed to be deleted (e.g. checking referential integrity rules).</td></tr><tr><td style=\"white-space:nowrap\">profile<a name=\"resource-validation-mode-profile\"> </a></td><td>Validate Against a Profile</td><td>The server checks an existing resource (must be nominated by id, not provided as a parameter) as valid against the nominated profile.</td></tr></table></div>"
  },
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "fhir"
  }],
  "url" : "http://hl7.org/fhir/resource-validation-mode",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.4.119"
  },
  {
    "use" : "old",
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.1.109"
  },
  {
    "use" : "old",
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.2.48"
  }],
  "version" : "5.0.0-draft-final",
  "name" : "ResourceValidationMode",
  "title" : "Resource Validation Mode",
  "status" : "draft",
  "experimental" : true,
  "publisher" : "HL7 International",
  "description" : "ResourceValidationMode",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "code" : "001",
      "display" : "World"
    }]
  }],
  "caseSensitive" : true,
  "content" : "complete",
  "concept" : [{
    "code" : "create",
    "display" : "Validate for Create",
    "definition" : "The server checks the content, and then checks that the content would be acceptable as a create (e.g. that the content would not violate any uniqueness constraints)."
  },
  {
    "code" : "update",
    "display" : "Validate for Update",
    "definition" : "The server checks the content, and then checks that it would accept it as an update against the nominated specific resource (e.g. that there are no changes to immutable fields the server does not allow to change and checking version integrity if appropriate)."
  },
  {
    "code" : "delete",
    "display" : "Validate for Delete",
    "definition" : "The server ignores the content and checks that the nominated resource is allowed to be deleted (e.g. checking referential integrity rules)."
  },
  {
    "code" : "profile",
    "display" : "Validate Against a Profile",
    "definition" : "The server checks an existing resource (must be nominated by id, not provided as a parameter) as valid against the nominated profile."
  }]

}
Turtle Template @prefix fhir: <http://hl7.org/fhir/> . [ a fhir:; fhir:nodeRole fhir:treeRoot; # if this is the parser root # from # from fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: ] Changes since R3 This resource did not exist in Release 2 This analysis is available as XML or JSON .

Structure Name Flags Card. Type Description & Constraints Evidence I TU DomainResource A research context or question + 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 Σ 0..1 uri Canonical identifier for this evidence, represented as a URI (globally unique) identifier Σ 0..* Identifier Additional identifier for the evidence version Σ 0..1 string Business version of the evidence name Σ I 0..1 string Name for this evidence (computer friendly) title Σ 0..1 string Name for this evidence (human friendly) shortTitle 0..1 string Title for use in informal contexts subtitle 0..1 string Subordinate title of the Evidence status ?! Σ 1..1 code draft | active | retired | unknown PublicationStatus ( Required ) date Σ 0..1 dateTime Date last changed publisher Σ 0..1 string Name of the publisher (organization or individual) contact Σ 0..* ContactDetail Contact details for the publisher description Σ 0..1 markdown Natural language description of the evidence note 0..* Annotation Used for footnotes or explanatory notes useContext Σ 0..* UsageContext The context that the content is intended to support jurisdiction Σ 0..* CodeableConcept Intended jurisdiction for evidence (if applicable) Jurisdiction ( Extensible ) copyright 0..1 markdown Use and/or publishing restrictions approvalDate 0..1 date When the evidence was approved by publisher lastReviewDate 0..1 date When the evidence was last reviewed effectivePeriod Σ 0..1 Period When the evidence is expected to be used topic 0..* CodeableConcept The category of the Evidence, such as Education, Treatment, Assessment, etc. DefinitionTopic ( Example ) author 0..* ContactDetail Who authored the content editor 0..* ContactDetail Who edited the content reviewer 0..* ContactDetail Who reviewed the content endorser 0..* ContactDetail Who endorsed the content relatedArtifact 0..* RelatedArtifact Additional documentation, citations, etc. exposureBackground Σ 1..1 Reference ( EvidenceVariable ) What population? exposureVariant Σ 0..* Reference ( EvidenceVariable ) What exposure? outcome Σ 0..* Reference ( EvidenceVariable ) What outcome? 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 evidence is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the evidence is stored on different servers url : uri [0..1] A formal identifier that is used to identify this evidence when it is represented in other formats, or referenced in a specification, model, design or an instance identifier : Identifier [0..*] The identifier that is used to identify this version of the evidence when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the evidence author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts version : string [0..1] A natural language name identifying the evidence. This name should be usable as an identifier for the module by machine processing applications such as code generation name : string [0..1] A short, descriptive, user-friendly title for the evidence title : string [0..1] The short title provides an alternate title for use in informal descriptive contexts where the full, formal title is not necessary shortTitle : string [0..1] An explanatory or alternate title for the Evidence giving additional information about its content subtitle : string [0..1] The status of this evidence. Enables tracking the life-cycle of the content (this element modifies the meaning of other elements) status : code [1..1] « The lifecycle status of an artifact. (Strength=Required) PublicationStatus ! » The date (and optionally time) when the evidence was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the evidence changes date : dateTime [0..1] The name of the organization or individual that published the evidence publisher : string [0..1] Contact details to assist a user in finding and communicating with the publisher contact : ContactDetail [0..*] A free text natural language description of the evidence from a consumer's perspective description : markdown [0..1] A human-readable string Usage note: every effort has been made to clarify or explain concepts about the resource note : Annotation [0..*] The content was developed with a focus and intent of supporting the contexts ensure that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate evidence instances useContext : UsageContext [0..*] A legal or geographic region in which the evidence is intended to be used jurisdiction : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use. (Strength=Extensible) Jurisdiction ValueSet + » A copyright statement relating to the evidence and/or its contents. Copyright statements examples are generally legal restrictions on the use correct and publishing of the evidence copyright : markdown [0..1] The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage approvalDate : date [0..1] The date on which the resource content was last reviewed. Review happens periodically after approval useful, but does they are not change the original approval date lastReviewDate : date [0..1] The period during which the evidence content was or is planned to be in active use effectivePeriod : Period [0..1] Descriptive topics related to the content of the Evidence. Topics provide a high-level categorization grouping types of Evidences that can be useful for filtering and searching topic : CodeableConcept [0..*] « High-level categorization of the definition, used for searching, sorting, and filtering. (Strength=Example) DefinitionTopic ?? » An individiual or organization primarily involved in the creation and maintenance of the content author : ContactDetail [0..*] An individual or organization primarily responsible for internal coherence of the content editor : ContactDetail [0..*] An individual or organization primarily responsible for review of some aspect normative part of the content reviewer : ContactDetail [0..*] An individual or organization responsible for officially endorsing the content for use in some setting endorser : ContactDetail [0..*] Related artifacts such as additional documentation, justification, or bibliographic references relatedArtifact : RelatedArtifact [0..*] A reference to a EvidenceVariable resource that defines the population for the research exposureBackground : Reference [1..1] « EvidenceVariable » A reference to a EvidenceVariable resource that defines the exposure for the research exposureVariant : Reference [0..*] « EvidenceVariable » A reference to a EvidenceVariable resomece that defines the outcome for the research outcome : Reference [0..*] « EvidenceVariable » XML Template < <!-- from --> <!-- from --> < <</identifier> < < < < < < < < <</contact> < <</note> <</useContext> <</jurisdiction> < < < <</effectivePeriod> <</topic> <</author> <</editor> <</reviewer> <</endorser> <</relatedArtifact> <</exposureBackground> <</exposureVariant> <</outcome> </Evidence> JSON Template specification.

{ "resourceType" : "", // from // from " " " " " " " " " " " " " " " " " " " " " " " " " " " " }
Turtle Template @prefix fhir: <http://hl7.org/fhir/> . [ a fhir:; fhir:nodeRole fhir:treeRoot; # if this is the parser root # from # from fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: ] Changes since Release 3 This resource did not exist in Release 2 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 14.9.3.1 Terminology Bindings Path Definition Type Reference Evidence.status The lifecycle status of an artifact. Required PublicationStatus Evidence.jurisdiction Countries and regions within which this artifact is targeted for use. Extensible Jurisdiction ValueSet Evidence.topic High-level categorization of the definition, used for searching, sorting, and filtering. Example DefinitionTopic 14.9.3.2 Constraints id Level Location Description Expression evi-0 Warning (base) Name should be usable as an identifier for the module by machine processing applications such as code generation name.matches('[A-Z]([A-Za-z0-9_]){0,254}') 14.9.4 Search Parameters Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services. Name Type Description Expression In Common composed-of reference What resource is being referenced Evidence.relatedArtifact.where(type='composed-of').resource (Any) context token A use context assigned to the evidence (Evidence.useContext.value as CodeableConcept) context-quantity quantity A quantity- or range-valued use context assigned to the evidence (Evidence.useContext.value as Quantity) | (Evidence.useContext.value as Range) context-type token A type of use context assigned to the evidence Evidence.useContext.code context-type-quantity composite A use context type and quantity- or range-based value assigned to the evidence On Evidence.useContext:   context-type: code   context-quantity: value.as(Quantity) | value.as(Range) context-type-value composite A use context type and value assigned to the evidence On Evidence.useContext:   context-type: code   context: value.as(CodeableConcept) date date The evidence publication date Evidence.date depends-on reference What resource is being referenced Evidence.relatedArtifact.where(type='depends-on').resource (Any) derived-from reference What resource is being referenced Evidence.relatedArtifact.where(type='derived-from').resource (Any) description string The description of the evidence Evidence.description effective date The time during which the evidence is intended to be in use Evidence.effectivePeriod identifier token External identifier for the evidence Evidence.identifier jurisdiction token Intended jurisdiction for the evidence Evidence.jurisdiction name string Computationally friendly name of the evidence Evidence.name predecessor reference What resource is being referenced Evidence.relatedArtifact.where(type='predecessor').resource (Any) publisher string Name of the publisher of the evidence Evidence.publisher status token The current status of the evidence Evidence.status successor reference What resource is being referenced Evidence.relatedArtifact.where(type='successor').resource (Any) title string The human-friendly name of the evidence Evidence.title topic token Topics associated with the Evidence Evidence.topic url uri The uri that identifies the evidence Evidence.url version token The business version of the evidence Evidence.version