<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="picoelement" />
  <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/picoelement" />
  <version value="4.0.0" />
  <name value="PICO Element 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="objimpl" />
    <uri value="http://hl7.org/fhir/object-implementation" />
    <name value="Object Implementation Information" />
  </mapping>
  <mapping>
    <identity value="w5" />
    <uri value="http://hl7.org/fhir/fivews" />
    <name value="FiveWs Pattern Mapping" />
  </mapping>
  <mapping>
    <identity value="rim" />
    <uri value="http://hl7.org/v3" />
    <name value="RIM Mapping" />
  </mapping>
  <kind value="resource" />
  <abstract value="false" />
  <type value="EvidenceVariable" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/EvidenceVariable" />
  <derivation value="constraint" />
  <differential>
    <element id="EvidenceVariable">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
        <valueString value="0;0" />
      </extension>
      <path value="EvidenceVariable" />
      <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="EvidenceVariable.identifier">
      <path value="EvidenceVariable.identifier" />
      <short value="Additional identifier for the evidence variable" />
      <definition value="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." />
      <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 variable 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="EvidenceVariable.title">
      <path value="EvidenceVariable.title" />
      <short value="Name for this evidence variable (human friendly)" />
      <definition value="A short, descriptive, user-friendly title for the evidence variable." />
      <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="EvidenceVariable.shortTitle">
      <path value="EvidenceVariable.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>
    </element>
    <element id="EvidenceVariable.date">
      <path value="EvidenceVariable.date" />
      <short value="Date last changed" />
      <definition value="The date  (and optionally time) when the evidence variable 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 variable 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 variable. 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="EvidenceVariable.description">
      <path value="EvidenceVariable.description" />
      <short value="Natural language description of the evidence variable" />
      <definition value="A free text natural language description of the evidence variable from a consumer's perspective." />
      <comment value="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)." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="markdown" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="Definition.description" />
      </mapping>
    </element>
    <element id="EvidenceVariable.note">
      <path value="EvidenceVariable.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="EvidenceVariable.type">
      <path value="EvidenceVariable.type" />
      <short value="dichotomous | continuous | descriptive" />
      <definition value="The type of evidence element, a population, an exposure, or an outcome." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="code" />
      </type>
    </element>
    <element id="EvidenceVariable.characteristic">
      <path value="EvidenceVariable.characteristic" />
      <short value="What defines the members of the evidence element" />
      <definition value="A characteristic that defines the members of the evidence element. Multiple characteristics are applied with &quot;and&quot; semantics." />
      <comment value="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." />
      <min value="1" />
      <max value="*" />
    </element>
    <element id="EvidenceVariable.characteristic.description">
      <path value="EvidenceVariable.characteristic.description" />
      <short value="Natural language description of the characteristic" />
      <definition value="A short, natural language description of the characteristic that could be used to communicate the criteria to an end-user." />
      <requirements value="Need to be able to describe characteristics in natural language so that end users can understand the criteria." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
    </element>
    <element id="EvidenceVariable.characteristic.definition[x]">
      <path value="EvidenceVariable.characteristic.definition[x]" />
      <short value="What code or expression defines members?" />
      <definition value="Define members of the evidence element using Codes (such as condition, medication, or observation), Expressions ( using an expression language such as FHIRPath or CQL) or DataRequirements (such as Diabetes diagnosis onset in the last year)." />
      <requirements value="Need to be able to define members in simple codes when the membership aligns well with terminology, with common criteria such as observations in a value set or lab tests within a year, or with expression language to support criteria that do not fit in the above." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
      </type>
      <type>
        <code value="canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ActivityDefinition" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Expression" />
      </type>
      <type>
        <code value="DataRequirement" />
      </type>
      <type>
        <code value="TriggerDefinition" />
      </type>
    </element>
    <element id="EvidenceVariable.characteristic.usageContext">
      <path value="EvidenceVariable.characteristic.usageContext" />
      <short value="What code/value pairs define members?" />
      <definition value="Use UsageContext to define the members of the population, such as Age Ranges, Genders, Settings." />
      <requirements value="Need to be able to define members more structurally when more information can be communicated such as age range." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="UsageContext" />
      </type>
    </element>
    <element id="EvidenceVariable.characteristic.exclude">
      <path value="EvidenceVariable.characteristic.exclude" />
      <short value="Whether the characteristic includes or excludes members" />
      <definition value="When true, members with this characteristic are excluded from the element." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="boolean" />
      </type>
    </element>
    <element id="EvidenceVariable.characteristic.participantEffective[x]">
      <path value="EvidenceVariable.characteristic.participantEffective[x]" />
      <short value="What time period do participants cover" />
      <definition value="Indicates what effective period the study covers." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <type>
        <code value="Duration" />
      </type>
      <type>
        <code value="Timing" />
      </type>
    </element>
    <element id="EvidenceVariable.characteristic.timeFromStart">
      <path value="EvidenceVariable.characteristic.timeFromStart" />
      <short value="Observation time from study start" />
      <definition value="Indicates duration from the participant's study entry." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Duration" />
      </type>
    </element>
    <element id="EvidenceVariable.characteristic.groupMeasure">
      <path value="EvidenceVariable.characteristic.groupMeasure" />
      <short value="mean | median | mean-of-mean | mean-of-median | median-of-mean | median-of-median" />
      <definition value="Indicates how elements are aggregated within the study effective period." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="code" />
      </type>
    </element>
  </differential>
</StructureDefinition>