<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="synthesis" />
  <text>
    <status value="generated" />
    <div xmlns="http://www.w3.org/1999/xhtml">to do</div>
  </text>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="0" />
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="cds" />
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use" />
  </extension>
  <url value="http://hl7.org/fhir/StructureDefinition/synthesis" />
  <version value="4.0.0" />
  <name value="Evidence Synthesis Profile" />
  <status value="draft" />
  <experimental value="false" />
  <date value="2018-10-31" />
  <publisher value="Health Level Seven, Inc. - Clinical Decision Support Workgroup" />
  <contact>
    <telecom>
      <system value="url" />
      <value value="http://www.hl7.org/Special/committees/dss/index.cfm" />
    </telecom>
  </contact>
  <description value="Explanation of what this profile contains/is for." />
  <purpose value="Need to be able to define and reuse the definition of individual elements of a research question." />
  <fhirVersion value="4.0.0" />
  <mapping>
    <identity value="workflow" />
    <uri value="http://hl7.org/fhir/workflow" />
    <name value="Workflow Pattern" />
  </mapping>
  <mapping>
    <identity value="w5" />
    <uri value="http://hl7.org/fhir/fivews" />
    <name value="FiveWs Pattern Mapping" />
  </mapping>
  <mapping>
    <identity value="objimpl" />
    <uri value="http://hl7.org/fhir/object-implementation" />
    <name value="Object Implementation Information" />
  </mapping>
  <mapping>
    <identity value="rim" />
    <uri value="http://hl7.org/v3" />
    <name value="RIM Mapping" />
  </mapping>
  <kind value="resource" />
  <abstract value="false" />
  <type value="Evidence" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Evidence" />
  <derivation value="constraint" />
  <differential>
    <element id="Evidence">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
        <valueString value="0;0" />
      </extension>
      <path value="Evidence" />
      <comment value="PICO stands for Population (the population within which exposures are being compared), Intervention (the conditional state or exposure state being described for its effect on outcomes), Comparison (the alternative conditional state or alternative exposure state being compared against), and Outcome (the result or effect of the intervention in the population)." />
      <min value="0" />
      <max value="*" />
      <mapping>
        <identity value="workflow" />
        <map value="Definition" />
      </mapping>
    </element>
    <element id="Evidence.url">
      <path value="Evidence.url" />
      <short value="Canonical identifier for this evidence, represented as a URI (globally unique)" />
      <definition value="An absolute URI that is used to identify this evidence when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this evidence is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the evidence is stored on different servers." />
      <comment value="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.&#xA;&#xA;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](resource.html#versions). &#xA;&#xA;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](resource.html#meta) element to indicate where the current master source of the resource can be found." />
      <requirements value="Allows the evidence to be referenced by a single globally unique identifier." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="uri" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Definition.url" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.identifier" />
      </mapping>
    </element>
    <element id="Evidence.identifier">
      <path value="Evidence.identifier" />
      <short value="Additional identifier for the evidence" />
      <definition value="A formal identifier that is used to identify this evidence when it is represented in other formats, or referenced in a specification, model, design or an instance." />
      <comment value="Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this evidence outside of FHIR, where it is not possible to use the logical URI." />
      <requirements value="Allows externally provided and/or usable business identifiers to be easily associated with the module." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Identifier" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Definition.identifier" />
      </mapping>
      <mapping>
        <identity value="objimpl" />
        <map value="no-gen-base" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.identifier" />
      </mapping>
    </element>
    <element id="Evidence.version">
      <path value="Evidence.version" />
      <short value="Business version of the evidence" />
      <definition value="The identifier that is used to identify this version of the evidence when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the evidence author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence." />
      <comment value="There may be different evidence 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 with the format [url]|[version]." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Definition.version" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.version" />
      </mapping>
    </element>
    <element id="Evidence.title">
      <path value="Evidence.title" />
      <short value="Name for this evidence (human friendly)" />
      <definition value="A short, descriptive, user-friendly title for the evidence." />
      <comment value="This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Definition.title" />
      </mapping>
    </element>
    <element id="Evidence.shortTitle">
      <path value="Evidence.shortTitle" />
      <short value="Title for use in informal contexts" />
      <definition value="The short title provides an alternate title for use in informal descriptive contexts where the full, formal title is not necessary." />
      <requirements value="Need to be able to reference the content by a short description, but still provide a longer, more formal title for the content." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="Definition.title" />
      </mapping>
    </element>
    <element id="Evidence.subtitle">
      <path value="Evidence.subtitle" />
      <short value="Subordinate title of the Evidence" />
      <definition value="An explanatory or alternate title for the Evidence giving additional information about its content." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
    </element>
    <element id="Evidence.status">
      <path value="Evidence.status" />
      <short value="draft | active | retired | unknown" />
      <definition value="The status of this evidence. Enables tracking the life-cycle of the content." />
      <comment value="Allows filtering of evidences that are appropriate for use versus not." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="code" />
      </type>
      <isModifier value="true" />
      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not use a retired {{title}} without due consideration" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="PublicationStatus" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true" />
        </extension>
        <strength value="required" />
        <description value="The lifecycle status of an artifact." />
        <valueSet value="http://hl7.org/fhir/ValueSet/publication-status|4.0.0" />
      </binding>
      <mapping>
        <identity value="workflow" />
        <map value="Definition.status" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.status" />
      </mapping>
    </element>
    <element id="Evidence.date">
      <path value="Evidence.date" />
      <short value="Date last changed" />
      <definition value="The date  (and optionally time) when the evidence was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the evidence changes." />
      <comment value="Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the evidence. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource." />
      <alias value="Revision Date" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="dateTime" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Definition.date" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.recorded" />
      </mapping>
    </element>
    <element id="Evidence.publisher">
      <path value="Evidence.publisher" />
      <short value="Name of the publisher (organization or individual)" />
      <definition value="The name of the organization or individual that published the evidence." />
      <comment value="Usually an organization but may be an individual. The publisher (or steward) of the evidence is the organization or individual primarily responsible for the maintenance and upkeep of the evidence. 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. This item SHOULD be populated unless the information is available from context." />
      <requirements value="Helps establish the &quot;authority/credibility&quot; of the evidence.  May also allow for contact." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Definition.publisher" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.witness" />
      </mapping>
    </element>
    <element id="Evidence.contact">
      <path value="Evidence.contact" />
      <short value="Contact details for the publisher" />
      <definition value="Contact details to assist a user in finding and communicating with the publisher." />
      <comment value="May be a web site, an email address, a telephone number, etc." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="ContactDetail" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Definition.contact" />
      </mapping>
    </element>
    <element id="Evidence.description">
      <path value="Evidence.description" />
      <short value="Natural language description of the evidence" />
      <definition value="A free text natural language description of the evidence from a consumer's perspective." />
      <comment value="This description can be used to capture details such as why the evidence 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 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 is presumed to be the predominant language in the place the evidence was created)." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="markdown" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="Definition.description" />
      </mapping>
    </element>
    <element id="Evidence.note">
      <path value="Evidence.note" />
      <short value="Used for footnotes or explanatory notes" />
      <definition value="A human-readable string to clarify or explain concepts about the resource." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Annotation" />
      </type>
    </element>
    <element id="Evidence.copyright">
      <path value="Evidence.copyright" />
      <short value="Use and/or publishing restrictions" />
      <definition value="A copyright statement relating to the evidence and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the evidence." />
      <requirements value="Consumers must be able to determine any legal restrictions on the use of the evidence and/or its content." />
      <alias value="License" />
      <alias value="Restrictions" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="markdown" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="Definition.copyright" />
      </mapping>
      <mapping>
        <identity value="objimpl" />
        <map value="no-gen-base" />
      </mapping>
    </element>
    <element id="Evidence.approvalDate">
      <path value="Evidence.approvalDate" />
      <short value="When the evidence was approved by publisher" />
      <definition value="The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage." />
      <comment value="The 'date' element may be more recent than the approval date because of minor changes or editorial corrections." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="date" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="Definition.approvalDate" />
      </mapping>
      <mapping>
        <identity value="objimpl" />
        <map value="no-gen-base" />
      </mapping>
    </element>
    <element id="Evidence.lastReviewDate">
      <path value="Evidence.lastReviewDate" />
      <short value="When the evidence was last reviewed" />
      <definition value="The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date." />
      <comment value="If specified, this date follows the original approval date." />
      <requirements value="Gives a sense of how &quot;current&quot; the content is.  Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="date" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="Definition.lastReviewDate" />
      </mapping>
      <mapping>
        <identity value="objimpl" />
        <map value="no-gen-base" />
      </mapping>
    </element>
    <element id="Evidence.author">
      <path value="Evidence.author" />
      <short value="Who authored the content" />
      <definition value="An individiual or organization primarily involved in the creation and maintenance of the content." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="ContactDetail" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=AUT]" />
      </mapping>
    </element>
    <element id="Evidence.editor">
      <path value="Evidence.editor" />
      <short value="Who edited the content" />
      <definition value="An individual or organization primarily responsible for internal coherence of the content." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="ContactDetail" />
      </type>
    </element>
    <element id="Evidence.reviewer">
      <path value="Evidence.reviewer" />
      <short value="Who reviewed the content" />
      <definition value="An individual or organization primarily responsible for review of some aspect of the content." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="ContactDetail" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=VRF] {not clear whether VRF best corresponds to reviewer or endorser}" />
      </mapping>
    </element>
    <element id="Evidence.relatedArtifact">
      <path value="Evidence.relatedArtifact" />
      <short value="Additional documentation, citations, etc." />
      <definition value="Related artifacts such as additional documentation, justification, or bibliographic references." />
      <comment value="Each related artifact is either an attachment, or a reference to another resource, but not both." />
      <requirements value="Evidences 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." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="RelatedArtifact" />
      </type>
    </element>
    <element id="Evidence.exposureBackground">
      <path value="Evidence.exposureBackground" />
      <short value="What population?" />
      <definition value="A reference to a EvidenceVariable resource that defines the population for the research." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/EvidenceVariable" />
      </type>
    </element>
    <element id="Evidence.exposureVariant">
      <path value="Evidence.exposureVariant" />
      <short value="What exposure?" />
      <definition value="A reference to a EvidenceVariable resource that defines the exposure for the research." />
      <min value="1" />
      <max value="2" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/EvidenceVariable" />
      </type>
    </element>
    <element id="Evidence.outcome">
      <path value="Evidence.outcome" />
      <short value="What outcome?" />
      <definition value="A reference to a EvidenceVariable resomece that defines the outcome for the research." />
      <min value="1" />
      <max value="*" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/EvidenceVariable" />
      </type>
    </element>
  </differential>
</StructureDefinition>