The EvidenceVariable resource describes a "PICO" an element that knowledge (evidence, assertion, recommendation) (Evidence) is about.

Need to be able to define and reuse the definition of individual elements of a research question.

PICO stands for Population (the population within which exposures are being compared), Intervention (the conditional state or The EvidenceVariable may be an exposure state being described for its effect on outcomes), Comparison (the alternative conditional state variable (intervention, condition, or alternative exposure state being compared against), and Outcome (the result state), a measured variable (outcome or effect of the intervention in the population). observed parameter), or other variable (such as confounding factor).

An absolute URI that is used to identify this evidence variable 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 variable is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the evidence variable is stored on different servers.

Allows the evidence variable to be referenced by a single globally unique identifier.

Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version. The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions . In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

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

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

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

The identifier that is used to identify this version of the evidence variable when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the evidence variable author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts.

There may be different evidence variable instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the evidence variable with the format [url]|[version]. The version SHOULD NOT contain a '#' - see Business Version .

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

If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 is newer, and a 0 if the version ordering can't successfully be determined.

A natural language name identifying the evidence variable. This name should be usable as an identifier for the module by machine processing applications such as code generation.

Support human navigation and code generation.

The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

A short, descriptive, user-friendly title for the evidence variable.

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

The short title provides an alternate title for use in informal descriptive contexts where the full, formal title is not necessary.

Need to be able to reference the content by a short description, but still provide a longer, more formal title for the content.

The status of this evidence variable. Enables tracking the life-cycle of the content.

Allows filtering of evidence variables that are appropriate for use versus not.

See guidance around (not) making local changes to elements here .

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.

The date (and optionally time) when the evidence variable 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 variable changes.

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

See guidance around (not) making local changes to elements here .

The name of the organization or individual that published responsible for the release and ongoing maintenance of the evidence variable.

Helps establish the "authority/credibility" of the evidence variable. May also allow for contact.

Usually an organization but may be an individual. The publisher (or steward) of the evidence variable is the organization or individual primarily responsible for the maintenance and upkeep of the evidence variable. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the evidence variable. This item SHOULD be populated unless the information is available from context.

Contact details to assist a user in finding and communicating with the publisher.

May be a web site, an email address, a telephone number, etc. Extensions to ContactDetail include: contactReference, contactAddress, and contributionTime (see Clinical Reasoning Module ).

See guidance around (not) making local changes to elements here .

A free text natural language description of the evidence variable from a consumer's perspective.

This description can be used to capture details such as why the evidence variable was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the evidence variable as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the evidence variable is presumed to be the predominant language in the place the evidence variable was created).

A human-readable string to clarify or explain concepts about the resource.

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 variable instances.

Assist in searching for appropriate content.

When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

A legal or geographic region in which the evidence variable Explanation of why this EvidenceVariable is intended to be used. needed and why it has been designed as it has.

It may be possible for This element does not describe the evidence variable to be used in jurisdictions other than those for which usage of the EvidenceVariable. Instead, it was originally designed provides traceability of ''why'' the resource is either needed or intended. To Do Note: ''why'' it is defined as it is. This was added back in because may be used to point to source materials or specifications that drove the structure of this is a metadata resource and it's a required element for metadata resource searching. EvidenceVariable.

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

A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').

Consumers must be able to determine any legal restrictions on Defines the use content expected to be rendered in all representations of the evidence variable and/or its content. artifact.

The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

See guidance around (not) making local changes to elements here .

The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

If specified, this date follows the original approval date.

See guidance around (not) making local changes to this resource. elements here .

The period during which the evidence variable resource content was or is planned to be in active use.

The effective period for a evidence variable an EvidenceVariable determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure variable intended to be used for the year 2016 might be published in 2015.

See guidance around (not) making local changes to this resource. elements here .

Descriptive topics related to An individiual or organization primarily involved in the content creation and maintenance of the EvidenceVariable. Topics provide a high-level categorization grouping types of EvidenceVariables that can be useful for filtering and searching. content.

Extensions to this resource. ContactDetail include: contactReference, contactAddress, and contributionTime (see Clinical Reasoning Module ).

An individiual individual or organization primarily involved in the creation and maintenance responsible for internal coherence of the content.

Extensions to ContactDetail include: contactReference, contactAddress, and contributionTime (see Clinical Reasoning Module ).

An individual or organization asserted by the publisher to be primarily responsible for review of some aspect of the content.

Extensions to ContactDetail include: contactReference, contactAddress, and contributionTime (see Clinical Reasoning Module ).

See guidance around (not) making local changes to elements here .

An individual or organization asserted by the publisher to be responsible for officially endorsing the content for use in some setting.

Extensions to ContactDetail include: contactReference, contactAddress, and contributionTime (see Clinical Reasoning Module ).

See guidance around (not) making local changes to elements here .

Related artifacts such as additional documentation, justification, or bibliographic references.

EvidenceVariables must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

Each related artifact is either an attachment, or a reference to another resource, but not both.

The type of evidence element, True if the actual variable measured, false if a population, an exposure, or an outcome. conceptual representation of the intended variable.

A characteristic that defines the members defining factor of the evidence element. EvidenceVariable. Multiple characteristics are applied with "and" semantics.

Characteristics can be defined flexibly to accommodate different use cases for membership criteria, ranging from simple codes, all the way to using an expression language to express the criteria.

Label used for when a characteristic refers to another characteristic.

A short, natural language description of the characteristic that could be used to communicate the criteria to an end-user.

Need to be able to describe characteristics in natural language so that end users can understand the criteria.

Define members A human-readable string to clarify or explain concepts about the characteristic.

When true, this characteristic is an exclusion criterion. In other words, not matching this characteristic definition is equivalent to meeting this criterion.

Defines the characteristic using a Reference.

Defines the evidence characteristic using Canonical.

Defines the characteristic using Codes (such as condition, medication, CodeableConcept.

Defines the characteristic using Expression.

When another element provides a definition of the characteristic, the definitionExpression content SHALL match the definition (only adding technical concepts necessary for implementation) without changing the meaning.

Defines the characteristic using id.

Defines the last year). characteristic using both a type and value[x] elements.

Used to express the type of characteristic.

Method for how the characteristic value was determined.

Device used for determining characteristic.

Defines the characteristic when paired with characteristic.type.

Need to be able to define members in simple codes Defines the reference point for comparison when valueQuantity or valueRange is not compared to zero.

Defines the membership aligns well with terminology, with common criteria such characteristic as observations in a value set or lab tests within a year, combination of two or with expression language to support criteria that do not fit in the above. more characteristics.

Use UsageContext Used to define the members of the population, such as Age Ranges, Genders, Settings. specify if two or more characteristics are combined with OR or AND.

Need to If code is "at-least" or "at-most" then threshold SHALL be able to define members more structurally when more information can used. If code is neither "at-least" nor "at-most" then threshold SHALL NOT be communicated such as age range. used.

Provides the value of "n" when multiple definition types "at-least" or "at-most" codes are present, used.

When true, members with this A defining factor of the characteristic.

Number of occurrences meeting the element. characteristic.

Indicates what effective period Length of time in which the study covers. characteristic is met.

Timing in which the characteristic is determined.

Human readable description.

A human-readable string to clarify or explain concepts about the timeFromEvent.

The event used as a base point (reference point) in time.

Indicates duration from Used to express the participant's study entry. observation at a defined amount of time before or after the event.

Indicates how elements are aggregated Used to express the observation within a period before and/or after the study effective period. event.

The method of handling in statistical analysis.

A grouping for ordinal or polychotomous variables.

Description of the grouping.

Definition of the grouping.