Release 4 5

This page is part of the FHIR Specification (v4.0.1: R4 (v5.0.0: R5 - Mixed Normative and STU ) ). This is the current published version 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

14.9 14.13 Resource Evidence - Content

Clinical Decision Support icon Work Group Maturity Level : 0 1   Trial Use Security Category : Business Compartments : Not linked to any No defined compartments

The Evidence resource describes Resource provides a machine-interpretable expression of an evidence concept including the conditional state (population and any exposures being compared within evidence variables (e.g., population, exposures/interventions, comparators, outcomes, measured variables, confounding variables), the population) statistics, and outcome (if specified) that the knowledge (evidence, assertion, recommendation) is about. certainty of this evidence.

14.9.1 14.13.1 Scope and Usage

The scope Evidence Resource enables the expression of the Evidence resource is to describe most granular form of evidence, such as the conditional state (population and exposures being considered or compared within actual quantitative results of a population) with study or without scientific analysis.

Human-readable summaries of the outcomes that knowledge (evidence, Evidence Resource may be expressed in description, assertion, recommendation) and note elements. The description element is about. typically used for the primary expression. The Evidence resource assertion element is a less commonly bundled series used and is typically used for interpretive expression. The note element may be used for any number of evidence variables from explanatory, variant, or related comments.

The variableDefinition element is used to describe what the "PICO" specification of medical knowledge: Population - evidence is about. Each variable defined must be assigned a variable role which signals how that variable is used in the population statistics within which exposures 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 outcomes EvidenceVariable Resources are being considered Intervention - used to define exposures and measured variables. The variableDefinition elements allows expression of the conditional state or exposure state being described for which one is expressing observed variable and the risk intended variable. In many forms of or effect on an outcome Comparison - expression the alternative conditional state or alternative exposure state when one Evidence is comparing states interpreted for a specific context and recognition of both observed and intended variables is important for understanding the effect on an outcome Outcome - applicability and certainty of the result or effect evidence.

The heart of an intervention or exposure in a population PICO (and its variants like PECO or PICOT) the evidence is the statistic. The statistic BackboneElement provides a universal acronym used in evidence-based medicine communities to clearly express research questions 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.

Because a statistic can rarely be interpreted without knowing how it was obtained, the Evidence Resource enables expression of the studyType . For evidence findings. The derived from synthesis of evidence, the Evidence resource allows Resource enables expression of the higher-order concept for recommendations synthesisType .

The certainty Element provides a machine-interpretable expression of certainty, confidence or quality of the resource in healthcare where multiple outcomes are considered, 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 higher-order concept/combination for framing research questions. certainty of evidence.

14.9.2

14.13.2 Boundaries and Relationships

The Evidence resource references 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 resource two or more times Resources to which an Evidence Resource points does not refer back to clearly specify the relationship among Evidence. In the context of evidence variable concepts in framing a research question, synthesis, an EvidenceVariable Resource may reference Evidence Resources where the EvidenceVariable Resource is used to define the set of evidence assertion, or recommendation. being synthesized.

14.13.3 References to this Resource

14.9.3 14.13.4 Resource Content

Structure

Σ ContactDetail ContactDetail Σ
Name Flags Card. Type Description & Constraints doco
. . Evidence I TU DomainResource A research context or question Single 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
Interfaces Implemented: MetadataResource
. . . url Σ C 0..1 uri Canonical identifier for this evidence, represented as a globally unique URI (globally unique)
+ Warning: URL should not contain | or # - these characters make processing canonical references problematic
. . . identifier Σ 0..* Identifier Additional identifier for the evidence summary

. . . version Σ 0..1 string Business version of the evidence this summary
. . name . versionAlgorithm[x] Σ I 0..1 How to compare versions
Binding: Version Algorithm ( Extensible )
.... versionAlgorithmString string
. . . . versionAlgorithmCoding Name for this evidence (computer friendly) Coding
. . . title name Σ C 0..1 string Name for this evidence (human summary (machine friendly)
. . . shortTitle title Σ T 0..1 string Title Name for use in informal contexts this summary (human friendly)
. . subtitle . citeAs[x] 0..1 0..1 Citation for this evidence
string
. . . . citeAsReference Reference ( Citation )
.... citeAsMarkdown Subordinate title of the Evidence markdown
. . . status ?! Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus ( Required )
. . . date experimental 0..1 boolean For testing purposes, not real usage
... date Σ 0..1 dateTime Date last changed
. . . approvalDate 0..1 date When the summary was approved by publisher
. . . publisher lastReviewDate 0..1 date When the summary was last reviewed by the publisher
... publisher Σ T 0..1 string Name of the publisher publisher/steward (organization or individual)
. . . contact Σ 0..* ContactDetail Contact details for the publisher

. . description . author Σ 0..* ContactDetail Who authored the content

... editor 0..1 0..* markdown ContactDetail Natural language description of Who edited the evidence content

. . . note reviewer 0..* Annotation ContactDetail Used for footnotes or explanatory notes Who reviewed the content

. . . useContext endorser Σ 0..* ContactDetail Who endorsed the content

... useContext Σ 0..* UsageContext The context that the content is intended to support

. . . purpose 0..1 markdown Why this Evidence is defined
. . jurisdiction . copyright 0..1 markdown Use and/or publishing restrictions
... copyrightLabel T 0..1 string Copyright holder and year(s)
... relatedArtifact 0..* CodeableConcept RelatedArtifact Intended jurisdiction for evidence (if applicable) Link or citation to artifact associated with the summary
Jurisdiction ( Extensible )
. . . copyright description T 0..1 markdown Use and/or publishing restrictions Description of the particular summary
. . . approvalDate assertion T 0..1 date markdown When Declarative description of the evidence was approved by publisher Evidence
. . lastReviewDate . note 0..* Annotation Footnotes and/or explanatory notes

... variableDefinition 1..* BackboneElement Evidence variable such as population, exposure, or outcome

.... description 0..1 date markdown When A text description or summary of the evidence was last reviewed variable
. . . . effectivePeriod note 0..* Annotation Footnotes and/or explanatory notes

.... variableRole Σ 1..1 CodeableConcept population | subpopulation | exposure | referenceExposure | measuredVariable | confounder
Binding: Evidence Variable Role ( Extensible )
.... observed Σ 0..1 Period Reference ( Group | EvidenceVariable ) When Definition of the evidence is expected actual variable related to be used the statistic(s)
. . . topic . intended 0..1 Reference ( Group | EvidenceVariable ) 0..* Definition of the intended variable related to the Evidence
.... directnessMatch 0..1 CodeableConcept low | moderate | high | exact
Binding: EvidenceDirectness icon ( Extensible )
... synthesisType 0..1 CodeableConcept The category of the Evidence, such as Education, Treatment, Assessment, etc. method to combine studies
Binding: StatisticSynthesisType icon DefinitionTopic ( Example Extensible )
. . . author studyDesign 0..* CodeableConcept The design of the study that produced this evidence
Binding: Study Design ( Extensible )

... statistic 0..* BackboneElement Values and parameters for a single statistic

.... description 0..1 markdown Who authored the Description of content
. . . . editor note 0..* Annotation 0..* Footnotes and/or explanatory notes

.... statisticType 0..1 CodeableConcept Type of statistic, e.g., relative risk
Binding: Statistic Type ( Extensible )
.... category 0..1 ContactDetail CodeableConcept Who edited the content Associated category for categorical variable
. . . . reviewer quantity 0..1 Quantity 0..* Statistic value
.... numberOfEvents 0..1 unsignedInt The number of events associated with the statistic
.... numberAffected 0..1 unsignedInt Who reviewed The number of participants affected
.... sampleSize 0..1 BackboneElement Number of samples in the content statistic
. . . . . description 0..1 markdown Textual description of sample size for statistic
... . . endorser note 0..* Annotation Footnote or explanatory note about the sample size

..... numberOfStudies 0..1 unsignedInt Number of contributing studies
..... numberOfParticipants 0..1 unsignedInt Cumulative number of participants
..... knownDataCount 0..1 unsignedInt Number of participants with known results for measured variables
. . . . attributeEstimate 0..* ContactDetail BackboneElement Who endorsed An attribute of the content Statistic

. . . . . description 0..1 markdown Textual description of the attribute estimate
..... note 0..* Annotation Footnote or explanatory note about the estimate

... . . relatedArtifact type 0..1 CodeableConcept The type of attribute estimate, e.g., confidence interval or p value
Binding: Attribute Estimate Type ( Extensible )
..... quantity 0..1 Quantity The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure
..... level 0..1 decimal Level of confidence interval, e.g., 0.95 for 95% confidence interval
..... range 0..1 Range Lower and upper bound values of the attribute estimate
..... attributeEstimate 0..* see attributeEstimate RelatedArtifact A nested attribute estimate; which is the attribute estimate of an attribute estimate

.... modelCharacteristic 0..* BackboneElement An aspect of the statistical model

..... code Additional documentation, citations, etc. 1..1 CodeableConcept Model specification
Binding: Statistic Model Code ( Extensible )
. . . . exposureBackground . value 0..1 SimpleQuantity Numerical value to complete model specification
..... variable 0..* BackboneElement A variable adjusted for in the adjusted analysis

...... variableDefinition 1..1 Reference ( Group | EvidenceVariable ) What population? Description of the variable
. . . . . exposureVariant . handling 0..1 Σ code continuous | dichotomous | ordinal | polychotomous
Binding: Evidence Variable Handling ( Required )
...... valueCategory 0..* Reference CodeableConcept ( EvidenceVariable Description for grouping of ordinal or polychotomous variables

...... valueQuantity ) What exposure? 0..* Quantity Discrete value for grouping of ordinal or polychotomous variables

. . . . . outcome . valueRange 0..* Σ Range Range of values for grouping of ordinal or polychotomous variables

..... attributeEstimate 0..* see attributeEstimate An attribute of the statistic used as a model characteristic

... certainty 0..* Reference BackboneElement Certainty or quality of the evidence

.... description 0..1 markdown Textual description of certainty
.... note 0..* Annotation Footnotes and/or explanatory notes

.... type 0..1 CodeableConcept Aspect of certainty being rated
Binding: Evidence Certainty Type ( EvidenceVariable Extensible )
. . . . rating What outcome? 0..1 CodeableConcept Assessment or judgement of the aspect
Binding: Evidence Certainty Rating ( Extensible )
.... rater 0..1 string Individual or group who did the rating
.... subcomponent 0..* see certainty A domain or subdomain of certainty


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

Evidence ( DomainResource ) + MetadataResource 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 summary is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the evidence summary is stored on different servers url : uri [0..1] A formal identifier that is used to identify this evidence summary 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 summary when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the evidence 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 sequence. To provide a sequence version consistent with the Decision Support Service specification, use : string [0..1] Indicates the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer mechanism used to the Decision Support Service specification. Note that a version compare versions to determine which is required for non-experimental active artifacts more current version versionAlgorithm[x] : string DataType [0..1] « string | Coding ; null (Strength=Extensible) VersionAlgorithm + » 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] « This element has or is affected by some invariants C » A short, descriptive, user-friendly title for the evidence summary title : string [0..1] The short title provides an alternate title Citation Resource or display of suggested citation for use in informal descriptive contexts where the full, formal title is not necessary this evidence shortTitle citeAs[x] : string DataType [0..1] An explanatory or alternate title for the Evidence giving additional information about its content subtitle « Reference : string ( Citation [0..1] )| markdown » The status of this evidence. summary. 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. null (Strength=Required) PublicationStatus ! » A Boolean value to indicate that this resource is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage experimental : boolean [0..1] The date (and optionally time) when the evidence summary was published. last significantly changed. 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 summary changes date : dateTime [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 name of the organization or individual that published responsible for the release and ongoing maintenance of 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 An individiual, organization, or device primarily involved in the creation and maintenance of the evidence from a consumer's perspective content description author : markdown ContactDetail [0..1] [0..*] A human-readable string to clarify An individiual, organization, or explain concepts about device primarily responsible for internal coherence of the resource content note editor : Annotation ContactDetail [0..*] An individiual, organization, or device primarily responsible for review of some aspect of the content reviewer : ContactDetail [0..*] An individiual, organization, or device responsible for officially endorsing the content for use in some setting endorser : ContactDetail [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 Explanation of why this Evidence is intended to be used needed and why it has been designed as it has jurisdiction purpose : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use. (Strength=Extensible) Jurisdiction ValueSet markdown + » [0..1] A copyright statement relating to the evidence Evidence and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the evidence Evidence copyright : markdown [0..1] The date on which A short string (<50 characters), suitable for inclusion in a page footer that identifies the resource content was approved by copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved') copyrightLabel : string [0..1] Link or citation to artifact associated with the publisher. Approval happens once when summary relatedArtifact : RelatedArtifact [0..*] A free text natural language description of the content is officially approved for usage evidence from a consumer's perspective approvalDate description : date markdown [0..1] The date on which the resource content was last reviewed. Review happens periodically after approval but does not change Declarative description of the original approval date Evidence lastReviewDate assertion : date markdown [0..1] Footnotes and/or explanatory notes note : Annotation [0..*] The period during which method to combine studies synthesisType : CodeableConcept [0..1] « null (Strength=Extensible) StatisticSynthesisType + » The design of the evidence content was or study that produced this evidence. The design is planned described with any number of study design characteristics studyDesign : CodeableConcept [0..*] « null (Strength=Extensible) StudyDesign + » VariableDefinition A text description or summary of the variable description : markdown [0..1] Footnotes and/or explanatory notes note : Annotation [0..*] population | subpopulation | exposure | referenceExposure | measuredVariable | confounder variableRole : CodeableConcept [1..1] « null (Strength=Extensible) EvidenceVariableRole + » Definition of the actual variable related to be in active use the statistic(s) effectivePeriod observed : Period Reference [0..1] « Group | EvidenceVariable » Descriptive topics Definition of the intended variable related to the Evidence intended : Reference [0..1] « Group | EvidenceVariable » Indication of quality of match between intended variable to actual variable directnessMatch : CodeableConcept [0..1] « null (Strength=Extensible) EvidenceDirectness + » Statistic A description of the content value of the Evidence. Topics provide a high-level categorization grouping types statistic description : markdown [0..1] Footnotes and/or explanatory notes note : Annotation [0..*] Type of Evidences that can be useful for filtering and searching statistic, e.g., relative risk topic statisticType : CodeableConcept [0..*] [0..1] « High-level categorization of null (Strength=Extensible) StatisticType + » When the definition, measured variable is handled categorically, the category element is used for searching, sorting, to define which category the statistic is reporting category : CodeableConcept [0..1] Statistic value quantity : Quantity [0..1] The number of events associated with the statistic, where the unit of analysis is different from numberAffected, sampleSize.knownDataCount and filtering. (Strength=Example) sampleSize.numberOfParticipants DefinitionTopic numberOfEvents ?? » : unsignedInt [0..1] An individiual or organization primarily involved in The number of participants affected where the creation unit of analysis is the same as sampleSize.knownDataCount and maintenance sampleSize.numberOfParticipants numberAffected : unsignedInt [0..1] SampleSize Human-readable summary of population sample size description : markdown [0..1] Footnote or explanatory note about the content sample size author note : ContactDetail Annotation [0..*] An individual or organization primarily responsible for internal coherence Number of participants in the content population editor numberOfStudies : ContactDetail unsignedInt [0..*] [0..1] An individual A human-readable string to clarify or organization primarily responsible for review explain concepts about the sample size numberOfParticipants : unsignedInt [0..1] Number of some aspect participants with known results for measured variables knownDataCount : unsignedInt [0..1] AttributeEstimate Human-readable summary of the content estimate reviewer description : ContactDetail markdown [0..*] [0..1] An individual Footnote or organization responsible for officially endorsing explanatory note about the content for use in some setting estimate endorser note : ContactDetail Annotation [0..*] Related artifacts such as additional documentation, justification, The type of attribute estimate, e.g., confidence interval or bibliographic references p value relatedArtifact type : RelatedArtifact CodeableConcept [0..*] [0..1] « null (Strength=Extensible) AttributeEstimateType + » A reference The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure quantity : Quantity [0..1] Use 95 for a EvidenceVariable resource that defines 95% confidence interval level : decimal [0..1] Lower bound of confidence interval range : Range [0..1] ModelCharacteristic Description of a component of the population for method to generate the research statistic exposureBackground code : Reference CodeableConcept [1..1] « EvidenceVariable null (Strength=Extensible) StatisticModelCode + » A reference Further specification of the quantified value of the component of the method to a EvidenceVariable resource that defines generate the exposure for statistic value : Quantity ( SimpleQuantity ) [0..1] Variable Description of the research variable exposureVariant variableDefinition : Reference [0..*] [1..1] « Group | EvidenceVariable » A reference to a EvidenceVariable resomece that defines How the outcome variable is classified for the research use in adjusted analysis outcome handling : Reference code [0..1] « null (Strength=Required) EvidenceVariableHandling ! » Description for grouping of ordinal or polychotomous variables valueCategory : CodeableConcept [0..*] Discrete value for grouping of ordinal or polychotomous variables valueQuantity : Quantity [0..*] Range of values for grouping of ordinal or polychotomous variables valueRange : Range [0..*] Certainty Textual description of certainty description : markdown [0..1] Footnotes and/or explanatory notes note : Annotation [0..*] Aspect of certainty being rated type : CodeableConcept [0..1] « EvidenceVariable null (Strength=Extensible) EvidenceCertaintyType + » Assessment or judgement of the aspect rating : CodeableConcept [0..1] « null (Strength=Extensible) EvidenceCertaintyRating + » Individual or group who did the rating rater : string [0..1] Evidence variable such as population, exposure, or outcome variableDefinition [1..*] Number of samples in the statistic sampleSize [0..1] A nested attribute estimate; which is the attribute estimate of an attribute estimate attributeEstimate [0..*] A statistical attribute of the statistic such as a measure of heterogeneity attributeEstimate [0..*] A variable adjusted for in the adjusted analysis variable [0..*] An attribute of the statistic used as a model characteristic attributeEstimate [0..*] A component of the method to generate the statistic modelCharacteristic [0..*] Values and parameters for a single statistic statistic [0..*] A domain or subdomain of certainty subcomponent [0..*] Assessment of certainty, confidence in the estimates, or quality of the evidence certainty [0..*]

XML Template 

<

<Evidence xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <
 <</identifier>
 <
 <
 <
 <
 <
 <
 <
 <

 <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 -->
 <versionAlgorithm[x]><!-- 0..1 string|Coding How to compare versions --></versionAlgorithm[x]>
 <name value="[string]"/><!-- I 0..1 Name for this summary (machine friendly) -->
 <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 -->
 <experimental value="[boolean]"/><!-- 0..1 For testing purposes, not real usage -->
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <approvalDate value="[date]"/><!-- 0..1 When the summary was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the summary was last reviewed by the publisher -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher/steward (organization or individual) -->

 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <
 <</note>

 <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>

 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <</jurisdiction>
 <
 <
 <
 <</effectivePeriod>
 <</topic>
 <</author>
 <</editor>
 <</reviewer>
 <</endorser>
 <</relatedArtifact>
 <</exposureBackground>
 <</exposureVariant>
 <</outcome>

 <purpose value="[markdown]"/><!-- 0..1 Why this Evidence is defined -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <copyrightLabel value="[string]"/><!-- 0..1 Copyright holder and year(s) -->
 <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 icon --></directnessMatch>
 </variableDefinition>
 <synthesisType><!-- 0..1 CodeableConcept The method to combine studies icon --></synthesisType>
 <studyDesign><!-- 0..* CodeableConcept The design of the study that produced this evidence --></studyDesign>
 <statistic>  <!-- 0..* Values and parameters for a single statistic -->
  <description value="[markdown]"/><!-- 0..1 Description of content -->
  <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
  <statisticType><!-- 0..1 CodeableConcept Type of statistic, e.g., relative risk --></statisticType>
  <category><!-- 0..1 CodeableConcept Associated category for categorical variable --></category>
  <quantity><!-- 0..1 Quantity Statistic value --></quantity>
  <numberOfEvents value="[unsignedInt]"/><!-- 0..1 The number of events associated with the statistic -->
  <numberAffected value="[unsignedInt]"/><!-- 0..1 The number of participants affected -->
  <sampleSize>  <!-- 0..1 Number of samples in the statistic -->
   <description value="[markdown]"/><!-- 0..1 Textual description of sample size for statistic -->
   <note><!-- 0..* Annotation Footnote or explanatory note about the sample size --></note>
   <numberOfStudies value="[unsignedInt]"/><!-- 0..1 Number of contributing studies -->
   <numberOfParticipants value="[unsignedInt]"/><!-- 0..1 Cumulative number of participants -->
   <knownDataCount value="[unsignedInt]"/><!-- 0..1 Number of participants with known results for measured variables -->
  </sampleSize>
  <attributeEstimate>  <!-- 0..* An attribute of the Statistic -->
   <description value="[markdown]"/><!-- 0..1 Textual description of the attribute estimate -->
   <note><!-- 0..* Annotation Footnote or explanatory note about the estimate --></note>
   <type><!-- 0..1 CodeableConcept The type of attribute estimate, e.g., confidence interval or p value --></type>
   <quantity><!-- 0..1 Quantity The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure --></quantity>
   <level value="[decimal]"/><!-- 0..1 Level of confidence interval, e.g., 0.95 for 95% confidence interval -->
   <range><!-- 0..1 Range Lower and upper bound values of the attribute estimate --></range>
   <attributeEstimate><!-- 0..* Content as for Evidence.statistic.attributeEstimate A nested attribute estimate; which is the attribute estimate of an attribute estimate --></attributeEstimate>
  </attributeEstimate>
  <modelCharacteristic>  <!-- 0..* An aspect of the statistical model -->
   <code><!-- 1..1 CodeableConcept Model specification --></code>
   <value><!-- 0..1 Quantity(SimpleQuantity) Numerical value to complete model specification --></value>
   <variable>  <!-- 0..* A variable adjusted for in the adjusted analysis -->
    <variableDefinition><!-- 1..1 Reference(EvidenceVariable|Group) Description of the variable --></variableDefinition>
    <handling value="[code]"/><!-- 0..1 continuous | dichotomous | ordinal | polychotomous -->
    <valueCategory><!-- 0..* CodeableConcept Description for grouping of ordinal or polychotomous variables --></valueCategory>
    <valueQuantity><!-- 0..* Quantity Discrete value for grouping of ordinal or polychotomous variables --></valueQuantity>
    <valueRange><!-- 0..* Range Range of values for grouping of ordinal or polychotomous variables --></valueRange>
   </variable>
   <attributeEstimate><!-- 0..* Content as for Evidence.statistic.attributeEstimate An attribute of the statistic used as a model characteristic --></attributeEstimate>
  </modelCharacteristic>
 </statistic>
 <certainty>  <!-- 0..* Certainty or quality of the evidence -->
  <description value="[markdown]"/><!-- 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" : "",

  "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
  // versionAlgorithm[x]: How to compare versions. One of these 2:

  "versionAlgorithmString" : "<string>",
  "versionAlgorithmCoding" : { Coding },
  "name" : "<string>", // I Name for this summary (machine friendly)
  "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
  "experimental" : <boolean>, // For testing purposes, not real usage
  "date" : "<dateTime>", // Date last changed
  "approvalDate" : "<date>", // When the summary was approved by publisher
  "lastReviewDate" : "<date>", // When the summary was last reviewed by the publisher
  "publisher" : "<string>", // Name of the publisher/steward (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

  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "

  "purpose" : "<markdown>", // Why this Evidence is defined
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "copyrightLabel" : "<string>", // Copyright holder and year(s)
  "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 icon
  }],
  "synthesisType" : { CodeableConcept }, // The method to combine studies icon
  "studyDesign" : [{ CodeableConcept }], // The design of the study that produced this evidence
  "statistic" : [{ // Values and parameters for a single statistic
    "description" : "<markdown>", // Description of content
    "note" : [{ Annotation }], // Footnotes and/or explanatory notes
    "statisticType" : { CodeableConcept }, // Type of statistic, e.g., relative risk
    "category" : { CodeableConcept }, // Associated category for categorical variable
    "quantity" : { Quantity }, // Statistic value
    "numberOfEvents" : "<unsignedInt>", // The number of events associated with the statistic
    "numberAffected" : "<unsignedInt>", // The number of participants affected
    "sampleSize" : { // Number of samples in the statistic
      "description" : "<markdown>", // Textual description of sample size for statistic
      "note" : [{ Annotation }], // Footnote or explanatory note about the sample size
      "numberOfStudies" : "<unsignedInt>", // Number of contributing studies
      "numberOfParticipants" : "<unsignedInt>", // Cumulative number of participants
      "knownDataCount" : "<unsignedInt>" // Number of participants with known results for measured variables
    },
    "attributeEstimate" : [{ // An attribute of the Statistic
      "description" : "<markdown>", // Textual description of the attribute estimate
      "note" : [{ Annotation }], // Footnote or explanatory note about the estimate
      "type" : { CodeableConcept }, // The type of attribute estimate, e.g., confidence interval or p value
      "quantity" : { Quantity }, // The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure
      "level" : <decimal>, // Level of confidence interval, e.g., 0.95 for 95% confidence interval
      "range" : { Range }, // Lower and upper bound values of the attribute estimate
      "attributeEstimate" : [{ Content as for Evidence.statistic.attributeEstimate }] // A nested attribute estimate; which is the attribute estimate of an attribute estimate
    }],
    "modelCharacteristic" : [{ // An aspect of the statistical model
      "code" : { CodeableConcept }, // R!  Model specification
      "value" : { Quantity(SimpleQuantity) }, // Numerical value to complete model specification
      "variable" : [{ // A variable adjusted for in the adjusted analysis
        "variableDefinition" : { Reference(EvidenceVariable|Group) }, // R!  Description of the variable
        "handling" : "<code>", // continuous | dichotomous | ordinal | polychotomous
        "valueCategory" : [{ CodeableConcept }], // Description for grouping of ordinal or polychotomous variables
        "valueQuantity" : [{ Quantity }], // Discrete value for grouping of ordinal or polychotomous variables
        "valueRange" : [{ Range }] // Range of values for grouping of ordinal or polychotomous variables
      }],
      "attributeEstimate" : [{ Content as for Evidence.statistic.attributeEstimate }] // An attribute of the statistic used as a model characteristic
    }]
  }],
  "certainty" : [{ // Certainty or quality of the evidence
    "description" : "<markdown>", // 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:;

[ 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:
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  fhir:url [ uri ] ; # 0..1 Canonical identifier for this evidence, represented as a globally unique URI
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Additional identifier for the summary
  fhir:version [ string ] ; # 0..1 Business version of this summary
  # versionAlgorithm[x] : 0..1 How to compare versions. One of these 2
    fhir:versionAlgorithm [  a fhir:string ; string ]
    fhir:versionAlgorithm [  a fhir:Coding ; Coding ]
  fhir:name [ string ] ; # 0..1 I Name for this summary (machine friendly)
  fhir:title [ string ] ; # 0..1 Name for this summary (human friendly)
  # citeAs[x] : 0..1 Citation for this evidence. One of these 2
    fhir:citeAs [  a fhir:Reference ; Reference(Citation) ]
    fhir:citeAs [  a fhir:markdown ; markdown ]
  fhir:status [ code ] ; # 1..1 draft | active | retired | unknown
  fhir:experimental [ boolean ] ; # 0..1 For testing purposes, not real usage
  fhir:date [ dateTime ] ; # 0..1 Date last changed
  fhir:approvalDate [ date ] ; # 0..1 When the summary was approved by publisher
  fhir:lastReviewDate [ date ] ; # 0..1 When the summary was last reviewed by the publisher
  fhir:publisher [ string ] ; # 0..1 Name of the publisher/steward (organization or individual)
  fhir:contact  ( [ ContactDetail ] ... ) ; # 0..* Contact details for the publisher
  fhir:author  ( [ ContactDetail ] ... ) ; # 0..* Who authored the content
  fhir:editor  ( [ ContactDetail ] ... ) ; # 0..* Who edited the content
  fhir:reviewer  ( [ ContactDetail ] ... ) ; # 0..* Who reviewed the content
  fhir:endorser  ( [ ContactDetail ] ... ) ; # 0..* Who endorsed the content
  fhir:useContext  ( [ UsageContext ] ... ) ; # 0..* The context that the content is intended to support
  fhir:purpose [ markdown ] ; # 0..1 Why this Evidence is defined
  fhir:copyright [ markdown ] ; # 0..1 Use and/or publishing restrictions
  fhir:copyrightLabel [ string ] ; # 0..1 Copyright holder and year(s)
  fhir:relatedArtifact  ( [ RelatedArtifact ] ... ) ; # 0..* Link or citation to artifact associated with the summary
  fhir:description [ markdown ] ; # 0..1 Description of the particular summary
  fhir:assertion [ markdown ] ; # 0..1 Declarative description of the Evidence
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
  fhir:variableDefinition ( [ # 1..* Evidence variable such as population, exposure, or outcome
    fhir:description [ markdown ] ; # 0..1 A text description or summary of the variable
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
    fhir:variableRole [ CodeableConcept ] ; # 1..1 population | subpopulation | exposure | referenceExposure | measuredVariable | confounder
    fhir:observed [ Reference(EvidenceVariable|Group) ] ; # 0..1 Definition of the actual variable related to the statistic(s)
    fhir:intended [ Reference(EvidenceVariable|Group) ] ; # 0..1 Definition of the intended variable related to the Evidence
    fhir:directnessMatch [ CodeableConcept ] ; # 0..1 low | moderate | high | exact
  ] ... ) ;
  fhir:synthesisType [ CodeableConcept ] ; # 0..1 The method to combine studies
  fhir:studyDesign  ( [ CodeableConcept ] ... ) ; # 0..* The design of the study that produced this evidence
  fhir:statistic ( [ # 0..* Values and parameters for a single statistic
    fhir:description [ markdown ] ; # 0..1 Description of content
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
    fhir:statisticType [ CodeableConcept ] ; # 0..1 Type of statistic, e.g., relative risk
    fhir:category [ CodeableConcept ] ; # 0..1 Associated category for categorical variable
    fhir:quantity [ Quantity ] ; # 0..1 Statistic value
    fhir:numberOfEvents [ unsignedInt ] ; # 0..1 The number of events associated with the statistic
    fhir:numberAffected [ unsignedInt ] ; # 0..1 The number of participants affected
    fhir:sampleSize [ # 0..1 Number of samples in the statistic
      fhir:description [ markdown ] ; # 0..1 Textual description of sample size for statistic
      fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnote or explanatory note about the sample size
      fhir:numberOfStudies [ unsignedInt ] ; # 0..1 Number of contributing studies
      fhir:numberOfParticipants [ unsignedInt ] ; # 0..1 Cumulative number of participants
      fhir:knownDataCount [ unsignedInt ] ; # 0..1 Number of participants with known results for measured variables
    ] ;
    fhir:attributeEstimate ( [ # 0..* An attribute of the Statistic
      fhir:description [ markdown ] ; # 0..1 Textual description of the attribute estimate
      fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnote or explanatory note about the estimate
      fhir:type [ CodeableConcept ] ; # 0..1 The type of attribute estimate, e.g., confidence interval or p value
      fhir:quantity [ Quantity ] ; # 0..1 The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure
      fhir:level [ decimal ] ; # 0..1 Level of confidence interval, e.g., 0.95 for 95% confidence interval
      fhir:range [ Range ] ; # 0..1 Lower and upper bound values of the attribute estimate
      fhir:attributeEstimate  ( [ See Evidence.statistic.attributeEstimate ] ... ) ; # 0..* A nested attribute estimate; which is the attribute estimate of an attribute estimate
    ] ... ) ;
    fhir:modelCharacteristic ( [ # 0..* An aspect of the statistical model
      fhir:code [ CodeableConcept ] ; # 1..1 Model specification
      fhir:value [ Quantity(SimpleQuantity) ] ; # 0..1 Numerical value to complete model specification
      fhir:variable ( [ # 0..* A variable adjusted for in the adjusted analysis
        fhir:variableDefinition [ Reference(EvidenceVariable|Group) ] ; # 1..1 Description of the variable
        fhir:handling [ code ] ; # 0..1 continuous | dichotomous | ordinal | polychotomous
        fhir:valueCategory  ( [ CodeableConcept ] ... ) ; # 0..* Description for grouping of ordinal or polychotomous variables
        fhir:valueQuantity  ( [ Quantity ] ... ) ; # 0..* Discrete value for grouping of ordinal or polychotomous variables
        fhir:valueRange  ( [ Range ] ... ) ; # 0..* Range of values for grouping of ordinal or polychotomous variables
      ] ... ) ;
      fhir:attributeEstimate  ( [ See Evidence.statistic.attributeEstimate ] ... ) ; # 0..* An attribute of the statistic used as a model characteristic
    ] ... ) ;
  ] ... ) ;
  fhir:certainty ( [ # 0..* Certainty or quality of the evidence
    fhir:description [ markdown ] ; # 0..1 Textual description of certainty
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
    fhir:type [ CodeableConcept ] ; # 0..1 Aspect of certainty being rated
    fhir:rating [ CodeableConcept ] ; # 0..1 Assessment or judgement of the aspect
    fhir:rater [ string ] ; # 0..1 Individual or group who did the rating
    fhir:subcomponent  ( [ See Evidence.certainty ] ... ) ; # 0..* A domain or subdomain of certainty
  ] ... ) ;

]

Changes since R3 from both R4 and R4B

Evidence
Evidence.versionAlgorithm[x]
  • Added Element
Evidence.citeAs[x]
  • Added Element
Evidence.experimental
  • Added Element
Evidence.purpose
  • Added Element
Evidence.copyrightLabel
  • Added Element
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.studyDesign
  • Added Element
Evidence.statistic
  • Added Element
Evidence.statistic.description
  • Added Element
Evidence.statistic.note
  • Added Element
Evidence.statistic.statisticType
  • Added Element
Evidence.statistic.category
  • Added Element
Evidence.statistic.quantity
  • Added Element
Evidence.statistic.numberOfEvents
  • Added Element
Evidence.statistic.numberAffected
  • Added Element
Evidence.statistic.sampleSize
  • Added Element
Evidence.statistic.sampleSize.description
  • Added Element
Evidence.statistic.sampleSize.note
  • Added Element
Evidence.statistic.sampleSize.numberOfStudies
  • Added Element
Evidence.statistic.sampleSize.numberOfParticipants
  • Added Element
Evidence.statistic.sampleSize.knownDataCount
  • Added Element
Evidence.statistic.attributeEstimate
  • Added Element
Evidence.statistic.attributeEstimate.description
  • Added Element
Evidence.statistic.attributeEstimate.note
  • Added Element
Evidence.statistic.attributeEstimate.type
  • Added Element
Evidence.statistic.attributeEstimate.quantity
  • Added Element
Evidence.statistic.attributeEstimate.level
  • Added Element
Evidence.statistic.attributeEstimate.range
  • Added Element
Evidence.statistic.attributeEstimate.attributeEstimate
  • Added Element
Evidence.statistic.modelCharacteristic
  • Added Element
Evidence.statistic.modelCharacteristic.code
  • Added Mandatory Element
Evidence.statistic.modelCharacteristic.value
  • Added Element
Evidence.statistic.modelCharacteristic.variable
  • Added Element
Evidence.statistic.modelCharacteristic.variable.variableDefinition
  • Added Mandatory Element
Evidence.statistic.modelCharacteristic.variable.handling
  • Added Element
Evidence.statistic.modelCharacteristic.variable.valueCategory
  • Added Element
Evidence.statistic.modelCharacteristic.variable.valueQuantity
  • Added Element
Evidence.statistic.modelCharacteristic.variable.valueRange
  • Added Element
Evidence.statistic.modelCharacteristic.attributeEstimate
  • 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.shortTitle
  • Deleted
Evidence.subtitle
  • Deleted
Evidence.jurisdiction
  • Deleted
Evidence.effectivePeriod
  • Deleted
Evidence.topic
  • Deleted
Evidence.exposureBackground
  • Deleted
Evidence.exposureVariant
  • Deleted
Evidence.outcome
  • Deleted

This resource did not exist in Release 2 See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .

Structure

Σ ContactDetail ContactDetail Σ Reference
Name Flags Card. Type Description & Constraints doco
. . Evidence I TU DomainResource A research context or question Single 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
Interfaces Implemented: MetadataResource
. . . url Σ C 0..1 uri Canonical identifier for this evidence, represented as a globally unique URI (globally unique)
+ Warning: URL should not contain | or # - these characters make processing canonical references problematic
. . . identifier Σ 0..* Identifier Additional identifier for the evidence summary

. . . version Σ 0..1 string Business version of the evidence this summary
. . name . versionAlgorithm[x] Σ I 0..1 How to compare versions
Binding: Version Algorithm ( Extensible )
.... versionAlgorithmString string
. . . . versionAlgorithmCoding Name for this evidence (computer friendly) Coding
. . . title name Σ C 0..1 string Name for this evidence (human summary (machine friendly)
. . . shortTitle title Σ T 0..1 string Title Name for use in informal contexts this summary (human friendly)
. . subtitle . citeAs[x] 0..1 0..1 Citation for this evidence
string
. . . . citeAsReference Reference ( Citation )
.... citeAsMarkdown Subordinate title of the Evidence markdown
. . . status ?! Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus ( Required )
. . . date experimental 0..1 boolean For testing purposes, not real usage
... date Σ 0..1 dateTime Date last changed
. . . approvalDate 0..1 date When the summary was approved by publisher
. . . publisher lastReviewDate 0..1 date When the summary was last reviewed by the publisher
... publisher Σ T 0..1 string Name of the publisher publisher/steward (organization or individual)
. . . contact Σ 0..* ContactDetail Contact details for the publisher

. . description . author Σ 0..* ContactDetail Who authored the content

... editor 0..1 0..* markdown ContactDetail Natural language description of Who edited the evidence content

. . . note reviewer 0..* Annotation ContactDetail Used for footnotes or explanatory notes Who reviewed the content

. . . useContext endorser Σ 0..* ContactDetail Who endorsed the content

... useContext Σ 0..* UsageContext The context that the content is intended to support

. . . purpose 0..1 markdown Why this Evidence is defined
. . jurisdiction . copyright 0..1 markdown Use and/or publishing restrictions
... copyrightLabel T 0..1 string Copyright holder and year(s)
... relatedArtifact 0..* CodeableConcept RelatedArtifact Intended jurisdiction for evidence (if applicable) Link or citation to artifact associated with the summary
Jurisdiction ( Extensible )
. . . copyright description T 0..1 markdown Use and/or publishing restrictions Description of the particular summary
. . . approvalDate assertion T 0..1 date markdown When Declarative description of the evidence was approved by publisher Evidence
. . lastReviewDate . note 0..* Annotation Footnotes and/or explanatory notes

... variableDefinition 1..* BackboneElement Evidence variable such as population, exposure, or outcome

.... description 0..1 date markdown When A text description or summary of the evidence was last reviewed variable
. . . . effectivePeriod note 0..* Annotation Footnotes and/or explanatory notes

.... variableRole Σ 1..1 CodeableConcept population | subpopulation | exposure | referenceExposure | measuredVariable | confounder
Binding: Evidence Variable Role ( Extensible )
.... observed Σ 0..1 Period Reference ( Group | EvidenceVariable ) When Definition of the evidence is expected actual variable related to be used the statistic(s)
. . . topic . intended 0..1 Reference ( Group | EvidenceVariable ) 0..* Definition of the intended variable related to the Evidence
.... directnessMatch 0..1 CodeableConcept low | moderate | high | exact
Binding: EvidenceDirectness icon ( Extensible )
... synthesisType 0..1 CodeableConcept The category of the Evidence, such as Education, Treatment, Assessment, etc. method to combine studies
Binding: StatisticSynthesisType icon DefinitionTopic ( Example Extensible )
. . . author studyDesign 0..* CodeableConcept The design of the study that produced this evidence
Binding: Study Design ( Extensible )

... statistic 0..* BackboneElement Values and parameters for a single statistic

.... description 0..1 markdown Who authored the Description of content
. . . . editor note 0..* Annotation 0..* Footnotes and/or explanatory notes

.... statisticType 0..1 CodeableConcept Type of statistic, e.g., relative risk
Binding: Statistic Type ( Extensible )
.... category 0..1 ContactDetail CodeableConcept Who edited the content Associated category for categorical variable
. . . . reviewer quantity 0..1 Quantity 0..* Statistic value
. . . . numberOfEvents 0..1 unsignedInt The number of events associated with the statistic
.... numberAffected 0..1 unsignedInt Who reviewed The number of participants affected
.... sampleSize 0..1 BackboneElement Number of samples in the content statistic
. . . . . description 0..1 markdown Textual description of sample size for statistic
... . . endorser note 0..* Annotation Footnote or explanatory note about the sample size

..... numberOfStudies 0..1 unsignedInt Number of contributing studies
..... numberOfParticipants 0..1 unsignedInt Cumulative number of participants
..... knownDataCount 0..1 unsignedInt Number of participants with known results for measured variables
.... attributeEstimate 0..* ContactDetail BackboneElement Who endorsed An attribute of the content Statistic

. . . . . description 0..1 markdown Textual description of the attribute estimate
..... note 0..* Annotation Footnote or explanatory note about the estimate

... . . relatedArtifact type 0..1 CodeableConcept The type of attribute estimate, e.g., confidence interval or p value
Binding: Attribute Estimate Type ( Extensible )
..... quantity 0..1 Quantity The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure
..... level 0..1 decimal Level of confidence interval, e.g., 0.95 for 95% confidence interval
..... range 0..1 Range Lower and upper bound values of the attribute estimate
..... attributeEstimate 0..* see attributeEstimate RelatedArtifact A nested attribute estimate; which is the attribute estimate of an attribute estimate

.... modelCharacteristic 0..* BackboneElement An aspect of the statistical model

..... code Additional documentation, citations, etc. 1..1 CodeableConcept Model specification
Binding: Statistic Model Code ( Extensible )
. . . . exposureBackground . value 0..1 Σ SimpleQuantity Numerical value to complete model specification
..... variable 0..* BackboneElement A variable adjusted for in the adjusted analysis

...... variableDefinition 1..1 Reference ( Group | EvidenceVariable ) What population? Description of the variable
. . . . . exposureVariant . handling 0..1 Σ code continuous | dichotomous | ordinal | polychotomous
Binding: Evidence Variable Handling ( Required )
...... valueCategory 0..* CodeableConcept Description for grouping of ordinal or polychotomous variables

...... valueQuantity 0..* Reference ( EvidenceVariable Quantity ) What exposure? Discrete value for grouping of ordinal or polychotomous variables

. . . . . outcome . valueRange 0..* Range Range of values for grouping of ordinal or polychotomous variables

..... attributeEstimate 0..* see attributeEstimate An attribute of the statistic used as a model characteristic

... certainty 0..* BackboneElement Certainty or quality of the evidence

.... description 0..1 markdown Textual description of certainty
.... note 0..* Annotation Footnotes and/or explanatory notes

.... type 0..1 CodeableConcept Aspect of certainty being rated
Binding: Evidence Certainty Type ( EvidenceVariable Extensible )
. . . . rating What outcome? 0..1 CodeableConcept Assessment or judgement of the aspect
Binding: Evidence Certainty Rating ( Extensible )
.... rater 0..1 string Individual or group who did the rating
.... subcomponent 0..* see certainty A domain or subdomain of certainty


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

Evidence ( DomainResource ) + MetadataResource 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 summary is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the evidence summary is stored on different servers url : uri [0..1] A formal identifier that is used to identify this evidence summary 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 summary when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the evidence 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 sequence. To provide a sequence version consistent with the Decision Support Service specification, use : string [0..1] Indicates the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer mechanism used to the Decision Support Service specification. Note that a version compare versions to determine which is required for non-experimental active artifacts more current version versionAlgorithm[x] : string DataType [0..1] « string | Coding ; null (Strength=Extensible) VersionAlgorithm + » 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] « This element has or is affected by some invariants C » A short, descriptive, user-friendly title for the evidence summary title : string [0..1] The short title provides an alternate title Citation Resource or display of suggested citation for use in informal descriptive contexts where the full, formal title is not necessary this evidence shortTitle citeAs[x] : string DataType [0..1] An explanatory or alternate title for the Evidence giving additional information about its content subtitle « Reference : string ( Citation [0..1] )| markdown » The status of this evidence. summary. 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. null (Strength=Required) PublicationStatus ! » A Boolean value to indicate that this resource is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage experimental : boolean [0..1] The date (and optionally time) when the evidence summary was published. last significantly changed. 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 summary changes date : dateTime [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 name of the organization or individual that published responsible for the release and ongoing maintenance of 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 An individiual, organization, or device primarily involved in the creation and maintenance of the evidence from a consumer's perspective content description author : markdown ContactDetail [0..1] [0..*] A human-readable string to clarify An individiual, organization, or explain concepts about device primarily responsible for internal coherence of the resource content note editor : Annotation ContactDetail [0..*] An individiual, organization, or device primarily responsible for review of some aspect of the content reviewer : ContactDetail [0..*] An individiual, organization, or device responsible for officially endorsing the content for use in some setting endorser : ContactDetail [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 Explanation of why this Evidence is intended to be used needed and why it has been designed as it has jurisdiction purpose : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use. (Strength=Extensible) Jurisdiction ValueSet markdown + » [0..1] A copyright statement relating to the evidence Evidence and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the evidence Evidence copyright : markdown [0..1] The date on which A short string (<50 characters), suitable for inclusion in a page footer that identifies the resource content was approved by copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved') copyrightLabel : string [0..1] Link or citation to artifact associated with the publisher. Approval happens once when summary relatedArtifact : RelatedArtifact [0..*] A free text natural language description of the content is officially approved for usage evidence from a consumer's perspective approvalDate description : date markdown [0..1] The date on which the resource content was last reviewed. Review happens periodically after approval but does not change Declarative description of the original approval date Evidence lastReviewDate assertion : date markdown [0..1] Footnotes and/or explanatory notes note : Annotation [0..*] The period during which method to combine studies synthesisType : CodeableConcept [0..1] « null (Strength=Extensible) StatisticSynthesisType + » The design of the evidence content was or study that produced this evidence. The design is planned described with any number of study design characteristics studyDesign : CodeableConcept [0..*] « null (Strength=Extensible) StudyDesign + » VariableDefinition A text description or summary of the variable description : markdown [0..1] Footnotes and/or explanatory notes note : Annotation [0..*] population | subpopulation | exposure | referenceExposure | measuredVariable | confounder variableRole : CodeableConcept [1..1] « null (Strength=Extensible) EvidenceVariableRole + » Definition of the actual variable related to be in active use the statistic(s) effectivePeriod observed : Period Reference [0..1] « Group | EvidenceVariable » Descriptive topics Definition of the intended variable related to the Evidence intended : Reference [0..1] « Group | EvidenceVariable » Indication of quality of match between intended variable to actual variable directnessMatch : CodeableConcept [0..1] « null (Strength=Extensible) EvidenceDirectness + » Statistic A description of the content value of the Evidence. Topics provide a high-level categorization grouping types statistic description : markdown [0..1] Footnotes and/or explanatory notes note : Annotation [0..*] Type of Evidences that can be useful for filtering and searching statistic, e.g., relative risk topic statisticType : CodeableConcept [0..*] [0..1] « High-level categorization of null (Strength=Extensible) StatisticType + » When the definition, measured variable is handled categorically, the category element is used for searching, sorting, to define which category the statistic is reporting category : CodeableConcept [0..1] Statistic value quantity : Quantity [0..1] The number of events associated with the statistic, where the unit of analysis is different from numberAffected, sampleSize.knownDataCount and filtering. (Strength=Example) sampleSize.numberOfParticipants DefinitionTopic numberOfEvents ?? » : unsignedInt [0..1] An individiual or organization primarily involved in The number of participants affected where the creation unit of analysis is the same as sampleSize.knownDataCount and maintenance sampleSize.numberOfParticipants numberAffected : unsignedInt [0..1] SampleSize Human-readable summary of population sample size description : markdown [0..1] Footnote or explanatory note about the content sample size author note : ContactDetail Annotation [0..*] An individual or organization primarily responsible for internal coherence Number of participants in the content population editor numberOfStudies : ContactDetail unsignedInt [0..*] [0..1] An individual A human-readable string to clarify or organization primarily responsible for review explain concepts about the sample size numberOfParticipants : unsignedInt [0..1] Number of some aspect participants with known results for measured variables knownDataCount : unsignedInt [0..1] AttributeEstimate Human-readable summary of the content estimate reviewer description : ContactDetail markdown [0..*] [0..1] An individual Footnote or organization responsible for officially endorsing explanatory note about the content for use in some setting estimate endorser note : ContactDetail Annotation [0..*] Related artifacts such as additional documentation, justification, The type of attribute estimate, e.g., confidence interval or bibliographic references p value relatedArtifact type : RelatedArtifact CodeableConcept [0..*] [0..1] « null (Strength=Extensible) AttributeEstimateType + » A reference The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure quantity : Quantity [0..1] Use 95 for a EvidenceVariable resource that defines 95% confidence interval level : decimal [0..1] Lower bound of confidence interval range : Range [0..1] ModelCharacteristic Description of a component of the population for method to generate the research statistic exposureBackground code : Reference CodeableConcept [1..1] « EvidenceVariable null (Strength=Extensible) StatisticModelCode + » A reference Further specification of the quantified value of the component of the method to a EvidenceVariable resource that defines generate the exposure for statistic value : Quantity ( SimpleQuantity ) [0..1] Variable Description of the research variable exposureVariant variableDefinition : Reference [0..*] [1..1] « Group | EvidenceVariable » A reference to a EvidenceVariable resomece that defines How the outcome variable is classified for the research use in adjusted analysis outcome handling : Reference code [0..1] « null (Strength=Required) EvidenceVariableHandling ! » Description for grouping of ordinal or polychotomous variables valueCategory : CodeableConcept [0..*] Discrete value for grouping of ordinal or polychotomous variables valueQuantity : Quantity [0..*] Range of values for grouping of ordinal or polychotomous variables valueRange : Range [0..*] Certainty Textual description of certainty description : markdown [0..1] Footnotes and/or explanatory notes note : Annotation [0..*] Aspect of certainty being rated type : CodeableConcept [0..1] « EvidenceVariable null (Strength=Extensible) EvidenceCertaintyType + » Assessment or judgement of the aspect rating : CodeableConcept [0..1] « null (Strength=Extensible) EvidenceCertaintyRating + » Individual or group who did the rating rater : string [0..1] Evidence variable such as population, exposure, or outcome variableDefinition [1..*] Number of samples in the statistic sampleSize [0..1] A nested attribute estimate; which is the attribute estimate of an attribute estimate attributeEstimate [0..*] A statistical attribute of the statistic such as a measure of heterogeneity attributeEstimate [0..*] A variable adjusted for in the adjusted analysis variable [0..*] An attribute of the statistic used as a model characteristic attributeEstimate [0..*] A component of the method to generate the statistic modelCharacteristic [0..*] Values and parameters for a single statistic statistic [0..*] A domain or subdomain of certainty subcomponent [0..*] Assessment of certainty, confidence in the estimates, or quality of the evidence certainty [0..*]

XML Template 

<

<Evidence xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <
 <</identifier>
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 <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 -->
 <versionAlgorithm[x]><!-- 0..1 string|Coding How to compare versions --></versionAlgorithm[x]>
 <name value="[string]"/><!-- I 0..1 Name for this summary (machine friendly) -->
 <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 -->
 <experimental value="[boolean]"/><!-- 0..1 For testing purposes, not real usage -->
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <approvalDate value="[date]"/><!-- 0..1 When the summary was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the summary was last reviewed by the publisher -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher/steward (organization or individual) -->

 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <
 <</note>

 <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>

 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <</jurisdiction>
 <
 <
 <
 <</effectivePeriod>
 <</topic>
 <</author>
 <</editor>
 <</reviewer>
 <</endorser>
 <</relatedArtifact>
 <</exposureBackground>
 <</exposureVariant>
 <</outcome>

 <purpose value="[markdown]"/><!-- 0..1 Why this Evidence is defined -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <copyrightLabel value="[string]"/><!-- 0..1 Copyright holder and year(s) -->
 <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 icon --></directnessMatch>
 </variableDefinition>
 <synthesisType><!-- 0..1 CodeableConcept The method to combine studies icon --></synthesisType>
 <studyDesign><!-- 0..* CodeableConcept The design of the study that produced this evidence --></studyDesign>
 <statistic>  <!-- 0..* Values and parameters for a single statistic -->
  <description value="[markdown]"/><!-- 0..1 Description of content -->
  <note><!-- 0..* Annotation Footnotes and/or explanatory notes --></note>
  <statisticType><!-- 0..1 CodeableConcept Type of statistic, e.g., relative risk --></statisticType>
  <category><!-- 0..1 CodeableConcept Associated category for categorical variable --></category>
  <quantity><!-- 0..1 Quantity Statistic value --></quantity>
  <numberOfEvents value="[unsignedInt]"/><!-- 0..1 The number of events associated with the statistic -->
  <numberAffected value="[unsignedInt]"/><!-- 0..1 The number of participants affected -->
  <sampleSize>  <!-- 0..1 Number of samples in the statistic -->
   <description value="[markdown]"/><!-- 0..1 Textual description of sample size for statistic -->
   <note><!-- 0..* Annotation Footnote or explanatory note about the sample size --></note>
   <numberOfStudies value="[unsignedInt]"/><!-- 0..1 Number of contributing studies -->
   <numberOfParticipants value="[unsignedInt]"/><!-- 0..1 Cumulative number of participants -->
   <knownDataCount value="[unsignedInt]"/><!-- 0..1 Number of participants with known results for measured variables -->
  </sampleSize>
  <attributeEstimate>  <!-- 0..* An attribute of the Statistic -->
   <description value="[markdown]"/><!-- 0..1 Textual description of the attribute estimate -->
   <note><!-- 0..* Annotation Footnote or explanatory note about the estimate --></note>
   <type><!-- 0..1 CodeableConcept The type of attribute estimate, e.g., confidence interval or p value --></type>
   <quantity><!-- 0..1 Quantity The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure --></quantity>
   <level value="[decimal]"/><!-- 0..1 Level of confidence interval, e.g., 0.95 for 95% confidence interval -->
   <range><!-- 0..1 Range Lower and upper bound values of the attribute estimate --></range>
   <attributeEstimate><!-- 0..* Content as for Evidence.statistic.attributeEstimate A nested attribute estimate; which is the attribute estimate of an attribute estimate --></attributeEstimate>
  </attributeEstimate>
  <modelCharacteristic>  <!-- 0..* An aspect of the statistical model -->
   <code><!-- 1..1 CodeableConcept Model specification --></code>
   <value><!-- 0..1 Quantity(SimpleQuantity) Numerical value to complete model specification --></value>
   <variable>  <!-- 0..* A variable adjusted for in the adjusted analysis -->
    <variableDefinition><!-- 1..1 Reference(EvidenceVariable|Group) Description of the variable --></variableDefinition>
    <handling value="[code]"/><!-- 0..1 continuous | dichotomous | ordinal | polychotomous -->
    <valueCategory><!-- 0..* CodeableConcept Description for grouping of ordinal or polychotomous variables --></valueCategory>
    <valueQuantity><!-- 0..* Quantity Discrete value for grouping of ordinal or polychotomous variables --></valueQuantity>
    <valueRange><!-- 0..* Range Range of values for grouping of ordinal or polychotomous variables --></valueRange>
   </variable>
   <attributeEstimate><!-- 0..* Content as for Evidence.statistic.attributeEstimate An attribute of the statistic used as a model characteristic --></attributeEstimate>
  </modelCharacteristic>
 </statistic>
 <certainty>  <!-- 0..* Certainty or quality of the evidence -->
  <description value="[markdown]"/><!-- 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" : "",

  "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
  // versionAlgorithm[x]: How to compare versions. One of these 2:

  "versionAlgorithmString" : "<string>",
  "versionAlgorithmCoding" : { Coding },
  "name" : "<string>", // I Name for this summary (machine friendly)
  "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
  "experimental" : <boolean>, // For testing purposes, not real usage
  "date" : "<dateTime>", // Date last changed
  "approvalDate" : "<date>", // When the summary was approved by publisher
  "lastReviewDate" : "<date>", // When the summary was last reviewed by the publisher
  "publisher" : "<string>", // Name of the publisher/steward (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

  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "

  "purpose" : "<markdown>", // Why this Evidence is defined
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "copyrightLabel" : "<string>", // Copyright holder and year(s)
  "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 icon
  }],
  "synthesisType" : { CodeableConcept }, // The method to combine studies icon
  "studyDesign" : [{ CodeableConcept }], // The design of the study that produced this evidence
  "statistic" : [{ // Values and parameters for a single statistic
    "description" : "<markdown>", // Description of content
    "note" : [{ Annotation }], // Footnotes and/or explanatory notes
    "statisticType" : { CodeableConcept }, // Type of statistic, e.g., relative risk
    "category" : { CodeableConcept }, // Associated category for categorical variable
    "quantity" : { Quantity }, // Statistic value
    "numberOfEvents" : "<unsignedInt>", // The number of events associated with the statistic
    "numberAffected" : "<unsignedInt>", // The number of participants affected
    "sampleSize" : { // Number of samples in the statistic
      "description" : "<markdown>", // Textual description of sample size for statistic
      "note" : [{ Annotation }], // Footnote or explanatory note about the sample size
      "numberOfStudies" : "<unsignedInt>", // Number of contributing studies
      "numberOfParticipants" : "<unsignedInt>", // Cumulative number of participants
      "knownDataCount" : "<unsignedInt>" // Number of participants with known results for measured variables
    },
    "attributeEstimate" : [{ // An attribute of the Statistic
      "description" : "<markdown>", // Textual description of the attribute estimate
      "note" : [{ Annotation }], // Footnote or explanatory note about the estimate
      "type" : { CodeableConcept }, // The type of attribute estimate, e.g., confidence interval or p value
      "quantity" : { Quantity }, // The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure
      "level" : <decimal>, // Level of confidence interval, e.g., 0.95 for 95% confidence interval
      "range" : { Range }, // Lower and upper bound values of the attribute estimate
      "attributeEstimate" : [{ Content as for Evidence.statistic.attributeEstimate }] // A nested attribute estimate; which is the attribute estimate of an attribute estimate
    }],
    "modelCharacteristic" : [{ // An aspect of the statistical model
      "code" : { CodeableConcept }, // R!  Model specification
      "value" : { Quantity(SimpleQuantity) }, // Numerical value to complete model specification
      "variable" : [{ // A variable adjusted for in the adjusted analysis
        "variableDefinition" : { Reference(EvidenceVariable|Group) }, // R!  Description of the variable
        "handling" : "<code>", // continuous | dichotomous | ordinal | polychotomous
        "valueCategory" : [{ CodeableConcept }], // Description for grouping of ordinal or polychotomous variables
        "valueQuantity" : [{ Quantity }], // Discrete value for grouping of ordinal or polychotomous variables
        "valueRange" : [{ Range }] // Range of values for grouping of ordinal or polychotomous variables
      }],
      "attributeEstimate" : [{ Content as for Evidence.statistic.attributeEstimate }] // An attribute of the statistic used as a model characteristic
    }]
  }],
  "certainty" : [{ // Certainty or quality of the evidence
    "description" : "<markdown>", // 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:;

[ 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:
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  fhir:
  fhir:
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  fhir:

  fhir:url [ uri ] ; # 0..1 Canonical identifier for this evidence, represented as a globally unique URI
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Additional identifier for the summary
  fhir:version [ string ] ; # 0..1 Business version of this summary
  # versionAlgorithm[x] : 0..1 How to compare versions. One of these 2
    fhir:versionAlgorithm [  a fhir:string ; string ]
    fhir:versionAlgorithm [  a fhir:Coding ; Coding ]
  fhir:name [ string ] ; # 0..1 I Name for this summary (machine friendly)
  fhir:title [ string ] ; # 0..1 Name for this summary (human friendly)
  # citeAs[x] : 0..1 Citation for this evidence. One of these 2
    fhir:citeAs [  a fhir:Reference ; Reference(Citation) ]
    fhir:citeAs [  a fhir:markdown ; markdown ]
  fhir:status [ code ] ; # 1..1 draft | active | retired | unknown
  fhir:experimental [ boolean ] ; # 0..1 For testing purposes, not real usage
  fhir:date [ dateTime ] ; # 0..1 Date last changed
  fhir:approvalDate [ date ] ; # 0..1 When the summary was approved by publisher
  fhir:lastReviewDate [ date ] ; # 0..1 When the summary was last reviewed by the publisher
  fhir:publisher [ string ] ; # 0..1 Name of the publisher/steward (organization or individual)
  fhir:contact  ( [ ContactDetail ] ... ) ; # 0..* Contact details for the publisher
  fhir:author  ( [ ContactDetail ] ... ) ; # 0..* Who authored the content
  fhir:editor  ( [ ContactDetail ] ... ) ; # 0..* Who edited the content
  fhir:reviewer  ( [ ContactDetail ] ... ) ; # 0..* Who reviewed the content
  fhir:endorser  ( [ ContactDetail ] ... ) ; # 0..* Who endorsed the content
  fhir:useContext  ( [ UsageContext ] ... ) ; # 0..* The context that the content is intended to support
  fhir:purpose [ markdown ] ; # 0..1 Why this Evidence is defined
  fhir:copyright [ markdown ] ; # 0..1 Use and/or publishing restrictions
  fhir:copyrightLabel [ string ] ; # 0..1 Copyright holder and year(s)
  fhir:relatedArtifact  ( [ RelatedArtifact ] ... ) ; # 0..* Link or citation to artifact associated with the summary
  fhir:description [ markdown ] ; # 0..1 Description of the particular summary
  fhir:assertion [ markdown ] ; # 0..1 Declarative description of the Evidence
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
  fhir:variableDefinition ( [ # 1..* Evidence variable such as population, exposure, or outcome
    fhir:description [ markdown ] ; # 0..1 A text description or summary of the variable
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
    fhir:variableRole [ CodeableConcept ] ; # 1..1 population | subpopulation | exposure | referenceExposure | measuredVariable | confounder
    fhir:observed [ Reference(EvidenceVariable|Group) ] ; # 0..1 Definition of the actual variable related to the statistic(s)
    fhir:intended [ Reference(EvidenceVariable|Group) ] ; # 0..1 Definition of the intended variable related to the Evidence
    fhir:directnessMatch [ CodeableConcept ] ; # 0..1 low | moderate | high | exact
  ] ... ) ;
  fhir:synthesisType [ CodeableConcept ] ; # 0..1 The method to combine studies
  fhir:studyDesign  ( [ CodeableConcept ] ... ) ; # 0..* The design of the study that produced this evidence
  fhir:statistic ( [ # 0..* Values and parameters for a single statistic
    fhir:description [ markdown ] ; # 0..1 Description of content
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
    fhir:statisticType [ CodeableConcept ] ; # 0..1 Type of statistic, e.g., relative risk
    fhir:category [ CodeableConcept ] ; # 0..1 Associated category for categorical variable
    fhir:quantity [ Quantity ] ; # 0..1 Statistic value
    fhir:numberOfEvents [ unsignedInt ] ; # 0..1 The number of events associated with the statistic
    fhir:numberAffected [ unsignedInt ] ; # 0..1 The number of participants affected
    fhir:sampleSize [ # 0..1 Number of samples in the statistic
      fhir:description [ markdown ] ; # 0..1 Textual description of sample size for statistic
      fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnote or explanatory note about the sample size
      fhir:numberOfStudies [ unsignedInt ] ; # 0..1 Number of contributing studies
      fhir:numberOfParticipants [ unsignedInt ] ; # 0..1 Cumulative number of participants
      fhir:knownDataCount [ unsignedInt ] ; # 0..1 Number of participants with known results for measured variables
    ] ;
    fhir:attributeEstimate ( [ # 0..* An attribute of the Statistic
      fhir:description [ markdown ] ; # 0..1 Textual description of the attribute estimate
      fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnote or explanatory note about the estimate
      fhir:type [ CodeableConcept ] ; # 0..1 The type of attribute estimate, e.g., confidence interval or p value
      fhir:quantity [ Quantity ] ; # 0..1 The singular quantity of the attribute estimate, for attribute estimates represented as single values; also used to report unit of measure
      fhir:level [ decimal ] ; # 0..1 Level of confidence interval, e.g., 0.95 for 95% confidence interval
      fhir:range [ Range ] ; # 0..1 Lower and upper bound values of the attribute estimate
      fhir:attributeEstimate  ( [ See Evidence.statistic.attributeEstimate ] ... ) ; # 0..* A nested attribute estimate; which is the attribute estimate of an attribute estimate
    ] ... ) ;
    fhir:modelCharacteristic ( [ # 0..* An aspect of the statistical model
      fhir:code [ CodeableConcept ] ; # 1..1 Model specification
      fhir:value [ Quantity(SimpleQuantity) ] ; # 0..1 Numerical value to complete model specification
      fhir:variable ( [ # 0..* A variable adjusted for in the adjusted analysis
        fhir:variableDefinition [ Reference(EvidenceVariable|Group) ] ; # 1..1 Description of the variable
        fhir:handling [ code ] ; # 0..1 continuous | dichotomous | ordinal | polychotomous
        fhir:valueCategory  ( [ CodeableConcept ] ... ) ; # 0..* Description for grouping of ordinal or polychotomous variables
        fhir:valueQuantity  ( [ Quantity ] ... ) ; # 0..* Discrete value for grouping of ordinal or polychotomous variables
        fhir:valueRange  ( [ Range ] ... ) ; # 0..* Range of values for grouping of ordinal or polychotomous variables
      ] ... ) ;
      fhir:attributeEstimate  ( [ See Evidence.statistic.attributeEstimate ] ... ) ; # 0..* An attribute of the statistic used as a model characteristic
    ] ... ) ;
  ] ... ) ;
  fhir:certainty ( [ # 0..* Certainty or quality of the evidence
    fhir:description [ markdown ] ; # 0..1 Textual description of certainty
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Footnotes and/or explanatory notes
    fhir:type [ CodeableConcept ] ; # 0..1 Aspect of certainty being rated
    fhir:rating [ CodeableConcept ] ; # 0..1 Assessment or judgement of the aspect
    fhir:rater [ string ] ; # 0..1 Individual or group who did the rating
    fhir:subcomponent  ( [ See Evidence.certainty ] ... ) ; # 0..* A domain or subdomain of certainty
  ] ... ) ;

]

Changes since Release 3 from both R4 and R4B

Evidence
Evidence.versionAlgorithm[x]
  • Added Element
Evidence.citeAs[x]
  • Added Element
Evidence.experimental
  • Added Element
Evidence.purpose
  • Added Element
Evidence.copyrightLabel
  • Added Element
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.studyDesign
  • Added Element
Evidence.statistic
  • Added Element
Evidence.statistic.description
  • Added Element
Evidence.statistic.note
  • Added Element
Evidence.statistic.statisticType
  • Added Element
Evidence.statistic.category
  • Added Element
Evidence.statistic.quantity
  • Added Element
Evidence.statistic.numberOfEvents
  • Added Element
Evidence.statistic.numberAffected
  • Added Element
Evidence.statistic.sampleSize
  • Added Element
Evidence.statistic.sampleSize.description
  • Added Element
Evidence.statistic.sampleSize.note
  • Added Element
Evidence.statistic.sampleSize.numberOfStudies
  • Added Element
Evidence.statistic.sampleSize.numberOfParticipants
  • Added Element
Evidence.statistic.sampleSize.knownDataCount
  • Added Element
Evidence.statistic.attributeEstimate
  • Added Element
Evidence.statistic.attributeEstimate.description
  • Added Element
Evidence.statistic.attributeEstimate.note
  • Added Element
Evidence.statistic.attributeEstimate.type
  • Added Element
Evidence.statistic.attributeEstimate.quantity
  • Added Element
Evidence.statistic.attributeEstimate.level
  • Added Element
Evidence.statistic.attributeEstimate.range
  • Added Element
Evidence.statistic.attributeEstimate.attributeEstimate
  • Added Element
Evidence.statistic.modelCharacteristic
  • Added Element
Evidence.statistic.modelCharacteristic.code
  • Added Mandatory Element
Evidence.statistic.modelCharacteristic.value
  • Added Element
Evidence.statistic.modelCharacteristic.variable
  • Added Element
Evidence.statistic.modelCharacteristic.variable.variableDefinition
  • Added Mandatory Element
Evidence.statistic.modelCharacteristic.variable.handling
  • Added Element
Evidence.statistic.modelCharacteristic.variable.valueCategory
  • Added Element
Evidence.statistic.modelCharacteristic.variable.valueQuantity
  • Added Element
Evidence.statistic.modelCharacteristic.variable.valueRange
  • Added Element
Evidence.statistic.modelCharacteristic.attributeEstimate
  • 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.shortTitle
  • Deleted
Evidence.subtitle
  • Deleted
Evidence.jurisdiction
  • Deleted
Evidence.effectivePeriod
  • Deleted
Evidence.topic
  • Deleted
Evidence.exposureBackground
  • Deleted
Evidence.exposureVariant
  • Deleted
Evidence.outcome
  • Deleted

This resource did not exist in Release 2 See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .

 

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

14.9.3.1 14.13.4.1 Terminology Bindings

Evidence.jurisdiction Evidence.topic
Path Definition ValueSet Type Reference Documentation
Evidence.versionAlgorithm[x] VersionAlgorithm Extensible

Indicates the mechanism used to compare versions to determine which is more current.

Evidence.status PublicationStatus Required

The lifecycle status of an artifact.

Evidence.variableDefinition.variableRole EvidenceVariableRole Required Extensible PublicationStatus

The role that the assertion variable plays.

Evidence.variableDefinition.directnessMatch EvidenceDirectness icon Extensible

The quality of how direct the match is.

Evidence.synthesisType Countries and regions within which this artifact StatisticSynthesisType icon Extensible

Types of combining results from a body of evidence (eg. summary data meta-analysis).

Evidence.studyDesign StudyDesign Extensible

This is targeted a set of terms for use. study design characteristics.

Evidence.statistic.statisticType StatisticType (a valid code from StatisticStatisticType icon ) Extensible Jurisdiction ValueSet

The type of a statistic, e.g. relative risk or mean

Evidence.statistic.attributeEstimate.type AttributeEstimateType (a valid code from StatisticAttribute Estimate Type icon ) Extensible

A statistic about a statistic, e.g. Confidence interval or p-value

Evidence.statistic.modelCharacteristic.code High-level categorization StatisticModelCode Extensible

The handling of the definition, used variable in statistical analysis for searching, sorting, and filtering. exposures or outcomes.

Evidence.statistic.modelCharacteristic.variable.handling EvidenceVariableHandling Example Required DefinitionTopic

The handling of the variable in statistical analysis for exposures or outcomes (E.g. Dichotomous, Continuous, Descriptive).

Evidence.certainty.type EvidenceCertaintyType Extensible

The aspect of quality, confidence, or certainty.

Evidence.certainty.rating EvidenceCertaintyRating Extensible

The assessment of quality, confidence, or certainty.

14.9.3.2 14.13.4.2 Constraints

id UniqueKey Level Location Description Expression
evi-0 img  cnl-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}') name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$')
img  cnl-1 Warning Evidence.url URL should not contain | or # - these characters make processing canonical references problematic exists() implies matches('^[^|# ]+$')

14.9.4 14.13.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource , and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

What resource is being referenced Evidence.relatedArtifact.where(type='depends-on').resource (Any) The time during which the evidence is intended to be in use Evidence.effectivePeriod Computationally friendly name of the evidence Evidence.name What resource is being referenced Evidence.relatedArtifact.where(type='successor').resource (Any) Topics associated with the Evidence Evidence.topic
Name Type Description Expression In Common
composed-of reference context 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) (Evidence.useContext.value.ofType(CodeableConcept)) 30 Resources
context-quantity quantity A quantity- or range-valued use context assigned to the evidence (Evidence.useContext.value as Quantity) (Evidence.useContext.value.ofType(Quantity)) | (Evidence.useContext.value as Range) (Evidence.useContext.value.ofType(Range)) 30 Resources
context-type token A type of use context assigned to the evidence Evidence.useContext.code 30 Resources
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.ofType(Quantity) | value.as(Range) value.ofType(Range) 		30 Resources
context-type-value composite A use context type and value assigned to the evidence On Evidence.useContext:
  context-type: code
  context: value.as(CodeableConcept) value.ofType(CodeableConcept) 		30 Resources
date date The evidence publication date Evidence.date depends-on reference 30 Resources
derived-from reference description What resource is being referenced Evidence.relatedArtifact.where(type='derived-from').resource (Any) description string The description of the evidence Evidence.description effective date 28 Resources
identifier token External identifier for the evidence Evidence.identifier jurisdiction token Intended jurisdiction for the evidence Evidence.jurisdiction name string 34 Resources
predecessor reference publisher What resource is being referenced Evidence.relatedArtifact.where(type='predecessor').resource (Any) publisher string Name of the publisher of the evidence Evidence.publisher 30 Resources
status token The current status of the evidence Evidence.status successor reference 35 Resources
title string The human-friendly name of the evidence Evidence.title topic token 27 Resources
url uri The uri that identifies the evidence Evidence.url 34 Resources
version token The business version of the evidence Evidence.version 30 Resources