Guidance

The recommendation justification is the boiler plate for linking evidence and evidence-to-decision information to a recommendation. In terms of Dissolve-E requirements, it shall allow to:

• Flag missing evidence for specific questions or topics

Linking Evidence and Justification to Recommendations

To ensure transparency and traceability, each recommendation can be supported by structured justification. This includes:

• Linking evidence used to derive the recommendation, outcome by outcome,
• Providing a structured summary of evidence-to-decision considerations (e.g., GRADE domains, consensus strength),
• Referencing individual studies when applicable.

This is achieved by combining two linked ArtifactAssessment profiles:

1. RecommendationJustification: summarizes how a recommendation was derived, including consensus strength and outcome-specific evidence summaries.
2. CertaintyOfEvidenceRating: evaluates the certainty of the evidence for a specific outcome, and optionally for individual studies.

Each outcome that contributed to the recommendation is documented as a separate content[evidence] entry in the RecommendationJustification. This entry then references a corresponding CertaintyOfEvidenceRating resource.

Example: Linking Evidence to a Recommendation

The following example shows how a justification can link multiple outcome-specific evidence ratings to one recommendation:

Instance: JustificationExample
InstanceOf: recommendation-justification
* artifactReference = Reference(GuidelineRecommendation/rec-001)
* workflowStatus = #applied

* content[recommendationRating]
  * component[strengthOfRecommendation].classifier = $cs-ebm-ig#strong
  * component[directionOfRecommendation].classifier = $vs-direction-of-recommendation#for
  * component[levelOfConsensus].classifier = vs-level-of-consensus#broad

* content[evidence][+]
  * type = $cs-ebm-ig#evidence
  * relatesTo
    * type = $cs-related-artifact-type#justification
    * targetReference = Reference(CertaintyOfEvidenceRating/mortality)

* content[evidence][+]
  * type = $cs-ebm-ig#evidence
  * relatesTo
    * type = $cs-related-artifact-type#justification
    * targetReference = Reference(CertaintyOfEvidenceRating/hospitalStay)

This structure supports separate evaluation of the certainty of evidence for each relevant outcome (e.g., mortality, hospital stay).

Example: Certainty of Evidence for an Outcome

Each CertaintyOfEvidenceRating references the structured outcome evidence and provides a rating of the certainty of evidence (e.g., GRADE).

Instance: CertaintyMortality
InstanceOf: certainty-of-evidence-rating
* artifactReference = Reference(OutcomeEvidence/mortality-effect)
* workflowStatus = #applied

* content[ratingSystem]
  * classifier = cs-evidence-rating-system#GRADE

* content[levelOfEvidence]
  * type = $cs-certainty-type#Overall
  * classifier = cs-rating-certainty-of-evidence#moderate

This pattern supports consistent documentation of certainty across outcomes and recommendations.

Optional: Referencing Individual Studies

If individual studies were assessed separately, each can be linked as a component within the corresponding content[evidence] in the RecommendationJustification:

* content[evidence][+]
  * type = $cs-ebm-ig#evidence
  * relatesTo.targetReference = Reference(CertaintyOfEvidenceRating/summary-mortality)
  * component[+]
    * type = $cs-ebm-ig#evidence
    * relatesTo.targetReference = Reference(CertaintyOfEvidenceRating/study123)

This structure enables separation of outcome-level summaries from individual study-level ratings, while still maintaining linkages between them.

Why this Structure?

Although the linkages span multiple resources (RecommendationJustification → CertaintyOfEvidenceRating → OutcomeEvidence → EvidenceVariable), this model supports:

• Precise referencing of both outcome-level and study-level evidence,
• Extensibility for structured meta-analysis,
• Compatibility with structured reporting of p-values, effect sizes, and certainty domains,
• Clean separation of evidence evaluation (CertaintyOfEvidenceRating) and recommendation reasoning (RecommendationJustification).

This design aligns with the Dissolve-E goal of structured, traceable, and standards-based documentation of how recommendations are derived from evidence.

Capturing Consensus Procedures for Recommendations

To promote transparency in how recommendations were developed, guidelines must include information on the consensus process used by the working group. This includes:

• The consensus method (e.g., Nominal Group Process, Delphi technique, Structured Consensus Conference),
• When consensus meetings took place,
• How consensus was achieved or revised across meetings.

This information is recorded in a dedicated Consensus Protocol section of the guideline composition, using the consensusProtocol slice. The content is unstructured and can be recorded as plain text, tables, or embedded HTML for maximum flexibility. Further slicing may be added in the future if structured encoding is needed.

Example in FSH

* section[+]
  * code = cs-guideline-sections#consensus-protocol "Consensus Protocol"
  * text.div = "<div xmlns='http://www.w3.org/1999/xhtml'><p>The guideline was developed using a Delphi process conducted in three rounds between January and March 2024. Final consensus was reached during a structured consensus conference on March 28, 2024.</p></div>"

This section helps users and reviewers understand the development methodology and fosters trust in the guideline’s legitimacy.

Including Conflict of Interest Declarations

To ensure transparency and mitigate potential bias, all guidelines must disclose conflicts of interest (COI) of contributors. This includes:

• Types of interests (e.g., paid consultancy, speaker fees, advisory board membership, intellectual property ownership),
• Relevance to the guideline topic,
• Declared consequences (e.g., restriction from voting or drafting).

Conflict of interest declarations are recorded in the competingInterests section of the guideline composition or specific recommendation. The content may be provided as structured tables or unstructured text (e.g., using HTML tables within text.div). This allows for clear presentation of COI data without enforcing a rigid schema.

Example in FSH

* section[+]
  * code = cs-guideline-sections#competing-interests "Competing Interests"
  * text.div = """
    <div xmlns="http://www.w3.org/1999/xhtml">
      <table>
        <thead><tr><th>Name</th><th>Interest</th><th>Relevance</th><th>Consequence</th></tr></thead>
        <tbody>
          <tr><td>Dr. Example</td><td>Consulting for PharmaCorp</td><td>High</td><td>Excluded from voting</td></tr>
        </tbody>
      </table>
    </div>
    """

Further extensions or slices may be introduced in the future to structure these items more granularly (e.g., per contributor or per category), but for now, the section allows flexible textual or tabular encoding of COI information as appropriate.

This approach supports compliance with AWMF and oncology guideline standards, enabling clear communication of potential bias while allowing guideline developers freedom in how they collect and present COI declarations.

This profile of a FHIR ArtifactAssessment is derived from the ArtifactAssessment FHIR resource.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ArtifactAssessment		0..*	ArtifactAssessment	Adds metadata-supported comments, classifiers or ratings related to a Resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
Slices for artifact[x]	Σ	1..1		The artifact assessed, commented upon or rated Slice: Unordered, Open by type:$this
artifactReference			Reference(Resource)
artifactCanonical			canonical(Any)
artifactUri			uri
artifact[x]:artifactReference	Σ	0..1	Reference(Recommendation)	The artifact assessed, commented upon or rated
Slices for content		0..*	BackboneElement	Comment, classifier, or rating content Slice: Unordered, Open by value:type
content:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content:recommendationRating		0..1	BackboneElement	Comment, classifier, or rating content
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: recommendation-rating
display		1..1	string	Representation defined by the system Fixed Value: Recommendation Rating
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for component		0..*	See content (ArtifactAssessment)	Comment, classifier, or rating content Slice: Unordered, Open by value:type
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
component:ratingSystem		0..1	BackboneElement	Comment, classifier, or rating content
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: rating-system
display		1..1	string	Representation defined by the system Fixed Value: Rating System
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
classifier		1..1	CodeableConcept	Rating, classifier, or assessment Binding: Evidence Rating System Value Set (preferred)
component:strengthOfRecommendation		0..1	BackboneElement	Comment, classifier, or rating content
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: strength-of-recommendation
display		1..1	string	Representation defined by the system Fixed Value: Strength of Recommendation
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
component:directionOfRecommendation		0..1	BackboneElement	Comment, classifier, or rating content
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: direction-of-recommendation
display		1..1	string	Representation defined by the system Fixed Value: Direction of Recommendation
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
classifier		1..1	CodeableConcept	​Rating, classifier, or assessment Binding: http://hl7.org/fhir/uv/cpg/ValueSet/cpg-recommendation-direction-vs (required)
component:levelOfConsensus		0..1	BackboneElement	Comment, classifier, or rating content
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.awmf.org/awmf.ig/CodeSystem/cs-awmf
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: level-of-consensus
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
classifier		1..1	CodeableConcept	Rating, classifier, or assessment Binding: Level Of Consensus (required)
content:searchStrategy		0..1	BackboneElement	Comment, classifier, or rating content
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SearchStrategy
display		1..1	string	Representation defined by the system Fixed Value: SearchStrategy
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
relatesTo		1..1	BackboneElement	Relationship to other Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	code	documentation | justification | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | specification-of | created-with | cite-as | summarizes Binding: ArtifactRelationshipType (required): The type of relationship to the related artifact.
Slices for target[x]		1..1	Reference(Resource)	The artifact that is related to this ArtifactAssessment Slice: Unordered, Closed by type:$this
target[x]:targetReference		1..1	Reference(SystematicReview)	The artifact that is related to this ArtifactAssessment
content:evidence		0..*	BackboneElement	Comment, classifier, or rating content
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: evidence
display		1..1	string	Representation defined by the system Fixed Value: Evidence
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
relatesTo		1..1	BackboneElement	Relationship to other Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	code	documentation | justification | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | specification-of | created-with | cite-as | summarizes Binding: ArtifactRelationshipType (required): The type of relationship to the related artifact. Required Pattern: justification
Slices for target[x]		1..1	Reference(Resource)	The artifact that is related to this ArtifactAssessment Slice: Unordered, Closed by type:$this
target[x]:targetReference		1..1	Reference(Certainty of Evidence Rating)	The artifact that is related to this ArtifactAssessment
component		0..*	BackboneElement	Comment, classifier, or rating content
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: evidence
display		1..1	string	Representation defined by the system Fixed Value: Evidence
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
relatesTo		1..1	BackboneElement	Relationship to other Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	code	documentation | justification | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | specification-of | created-with | cite-as | summarizes Binding: ArtifactRelationshipType (required): The type of relationship to the related artifact.
Slices for target[x]		1..1	Reference(Resource)	The artifact that is related to this ArtifactAssessment Slice: Unordered, Closed by type:$this
target[x]:targetReference		1..1	Reference(Certainty of Evidence Rating)	The artifact that is related to this ArtifactAssessment
workflowStatus	Σ	1..1	code	submitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published | entered-in-error Binding: ArtifactAssessmentWorkflowStatus (required) Required Pattern: applied
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ArtifactAssessment.content:recommendationRating.type	example	Pattern Value: recommendation-rating("Recommendation Rating") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:recommendationRating.component:ratingSystem.type	example	Pattern Value: rating-system("Rating System") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:recommendationRating.component:ratingSystem.classifier	preferred	EvidenceRatingSystemVS(a valid code from Evidence Rating System Code System) http://fhir.awmf.org/awmf.ig/ValueSet/vs-evidence-rating-system From this IG
ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.type	example	Pattern Value: strength-of-recommendation("Strength of Recommendation") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.type	example	Pattern Value: direction-of-recommendation("Direction of Recommendation") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.classifier	required	​http://hl7.org/fhir/uv/cpg/ValueSet/cpg-recommendation-direction-vs http://hl7.org/fhir/uv/cpg/ValueSet/cpg-recommendation-direction-vs
ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.type	example	Pattern Value: level-of-consensus http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.classifier	required	LevelOfConsensusVS(a valid code from Level of Consensus) http://fhir.awmf.org/awmf.ig/ValueSet/vs-level-of-consensus From this IG
ArtifactAssessment.content:searchStrategy.type	example	Pattern Value: SearchStrategy("SearchStrategy") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:searchStrategy.relatesTo.type	required	ArtifactRelationshipType http://hl7.org/fhir/ValueSet/artifact-relationship-type|6.0.0-ballot3 From the FHIR Standard
ArtifactAssessment.content:evidence.type	example	Pattern Value: evidence("Evidence") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:evidence.relatesTo.type	required	Pattern Value: justification http://hl7.org/fhir/ValueSet/artifact-relationship-type|6.0.0-ballot3 From the FHIR Standard
ArtifactAssessment.content:evidence.component.type	example	Pattern Value: evidence("Evidence") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:evidence.component.relatesTo.type	required	ArtifactRelationshipType http://hl7.org/fhir/ValueSet/artifact-relationship-type|6.0.0-ballot3 From the FHIR Standard
ArtifactAssessment.workflowStatus	required	Pattern Value: applied http://hl7.org/fhir/ValueSet/artifactassessment-workflow-status|6.0.0-ballot3 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	ArtifactAssessment	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ArtifactAssessment	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ArtifactAssessment	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ArtifactAssessment	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ArtifactAssessment	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())

This structure is derived from ArtifactAssessment

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ArtifactAssessment		0..*	ArtifactAssessment	Adds metadata-supported comments, classifiers or ratings related to a Resource
Slices for artifact[x]		1..1	Reference(Resource), canonical(), uri	The artifact assessed, commented upon or rated Slice: Unordered, Open by type:$this
artifact[x]:artifactReference		0..1	Reference(Recommendation)	The artifact assessed, commented upon or rated
Slices for content		0..*	BackboneElement	Comment, classifier, or rating content Slice: Unordered, Open by value:type
content:recommendationRating		0..1	BackboneElement	Comment, classifier, or rating content
type		1..1	CodeableConcept	What type of content Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
code		1..1	code	Symbol in syntax defined by the system Fixed Value: recommendation-rating
display		1..1	string	Representation defined by the system Fixed Value: Recommendation Rating
Slices for component		0..*		Comment, classifier, or rating content Slice: Unordered, Open by value:type
component:ratingSystem		0..1	BackboneElement	Comment, classifier, or rating content
type		1..1	CodeableConcept	What type of content Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
code		1..1	code	Symbol in syntax defined by the system Fixed Value: rating-system
display		1..1	string	Representation defined by the system Fixed Value: Rating System
classifier		1..1	CodeableConcept	Rating, classifier, or assessment Binding: Evidence Rating System Value Set (preferred)
component:strengthOfRecommendation		0..1	BackboneElement	Comment, classifier, or rating content
type		1..1	CodeableConcept	What type of content Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
code		1..1	code	Symbol in syntax defined by the system Fixed Value: strength-of-recommendation
display		1..1	string	Representation defined by the system Fixed Value: Strength of Recommendation
component:directionOfRecommendation		0..1	BackboneElement	Comment, classifier, or rating content
type		1..1	CodeableConcept	What type of content Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
code		1..1	code	Symbol in syntax defined by the system Fixed Value: direction-of-recommendation
display		1..1	string	Representation defined by the system Fixed Value: Direction of Recommendation
classifier		1..1	CodeableConcept	​Rating, classifier, or assessment Binding: http://hl7.org/fhir/uv/cpg/ValueSet/cpg-recommendation-direction-vs (required)
component:levelOfConsensus		0..1	BackboneElement	Comment, classifier, or rating content
type		1..1	CodeableConcept	What type of content Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.awmf.org/awmf.ig/CodeSystem/cs-awmf
code		1..1	code	Symbol in syntax defined by the system Fixed Value: level-of-consensus
classifier		1..1	CodeableConcept	Rating, classifier, or assessment Binding: Level Of Consensus (required)
content:searchStrategy		0..1	BackboneElement	Comment, classifier, or rating content
type		1..1	CodeableConcept	What type of content Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SearchStrategy
display		1..1	string	Representation defined by the system Fixed Value: SearchStrategy
relatesTo		1..1	BackboneElement	Relationship to other Resources
Slices for target[x]		1..1	Reference(Resource)	The artifact that is related to this ArtifactAssessment Slice: Unordered, Open by type:$this
target[x]:targetReference		1..1	Reference(SystematicReview)	The artifact that is related to this ArtifactAssessment
content:evidence		0..*	BackboneElement	Comment, classifier, or rating content
type		1..1	CodeableConcept	What type of content Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
code		1..1	code	Symbol in syntax defined by the system Fixed Value: evidence
display		1..1	string	Representation defined by the system Fixed Value: Evidence
relatesTo		1..1	BackboneElement	Relationship to other Resources
type		1..1	code	documentation | justification | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | specification-of | created-with | cite-as | summarizes Required Pattern: justification
Slices for target[x]		1..1	Reference(Resource)	The artifact that is related to this ArtifactAssessment Slice: Unordered, Open by type:$this
target[x]:targetReference		1..1	Reference(Certainty of Evidence Rating)	The artifact that is related to this ArtifactAssessment
component		0..*	BackboneElement	Comment, classifier, or rating content
type		1..1	CodeableConcept	What type of content Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
code		1..1	code	Symbol in syntax defined by the system Fixed Value: evidence
display		1..1	string	Representation defined by the system Fixed Value: Evidence
relatesTo		1..1	BackboneElement	Relationship to other Resources
Slices for target[x]		1..1	Reference(Resource)	The artifact that is related to this ArtifactAssessment Slice: Unordered, Open by type:$this
target[x]:targetReference		1..1	Reference(Certainty of Evidence Rating)	The artifact that is related to this ArtifactAssessment
workflowStatus		1..1	code	submitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published | entered-in-error Required Pattern: applied
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
ArtifactAssessment.content:recommendationRating.component:ratingSystem.classifier	preferred	EvidenceRatingSystemVS(a valid code from Evidence Rating System Code System) http://fhir.awmf.org/awmf.ig/ValueSet/vs-evidence-rating-system From this IG
ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.classifier	required	​http://hl7.org/fhir/uv/cpg/ValueSet/cpg-recommendation-direction-vs http://hl7.org/fhir/uv/cpg/ValueSet/cpg-recommendation-direction-vs
ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.classifier	required	LevelOfConsensusVS(a valid code from Level of Consensus) http://fhir.awmf.org/awmf.ig/ValueSet/vs-level-of-consensus From this IG

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ArtifactAssessment		0..*	ArtifactAssessment	Adds metadata-supported comments, classifiers or ratings related to a Resource
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Additional identifier for the artifact assessment
title	Σ	0..1	string	A label for use in displaying and selecting the artifact assessment
citeAs		0..1	markdown	How to cite the comment or rating
Slices for artifact[x]	Σ	1..1		The artifact assessed, commented upon or rated Slice: Unordered, Open by type:$this
artifactReference			Reference(Resource)
artifactCanonical			canonical(Any)
artifactUri			uri
artifact[x]:artifactReference	Σ	0..1	Reference(Recommendation)	The artifact assessed, commented upon or rated
relatesTo		0..*	BackboneElement	Relationship to other Resources
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	code	documentation | justification | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | specification-of | created-with | cite-as | summarizes Binding: ArtifactRelationshipType (required): The type of relationship to the related artifact.
target[x]		1..1		The artifact that is related to this ArtifactAssessment
targetUri			uri
targetAttachment			Attachment
targetCanonical			canonical(Resource)
targetReference			Reference(Resource)
targetMarkdown			markdown
date	Σ	0..1	dateTime	Date last changed
copyright		0..1	markdown	Use and/or publishing restrictions
approvalDate		0..1	date	When the artifact assessment was approved by publisher
lastReviewDate	Σ	0..1	date	When the artifact assessment was last reviewed by the publisher
Slices for content		0..*	BackboneElement	Comment, classifier, or rating content Slice: Unordered, Open by value:type
content:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary		0..1	markdown	Brief summary of the content
type		0..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example)
classifier		0..*	CodeableConcept	Rating, classifier, or assessment Binding: EvidenceCertaintyRating (example)
quantity		0..1	Quantity	Quantitative rating
author		0..*	Reference(Patient | Practitioner | PractitionerRole | Organization | Device)	Who authored the content
path		0..*	uri	What the comment is directed to
relatesTo		0..*	See relatesTo (ArtifactAssessment)	Relationship to other Resources
freeToShare		0..1	boolean	Acceptable to publicly share the content
component		0..*	See content (ArtifactAssessment)	Comment, classifier, or rating content
content:recommendationRating		0..1	BackboneElement	Comment, classifier, or rating content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary		0..1	markdown	Brief summary of the content
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: recommendation-rating
display		1..1	string	Representation defined by the system Fixed Value: Recommendation Rating
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
classifier		0..*	CodeableConcept	Rating, classifier, or assessment Binding: EvidenceCertaintyRating (example)
quantity		0..1	Quantity	Quantitative rating
author		0..*	Reference(Patient | Practitioner | PractitionerRole | Organization | Device)	Who authored the content
path		0..*	uri	What the comment is directed to
relatesTo		0..*	See relatesTo (ArtifactAssessment)	Relationship to other Resources
freeToShare		0..1	boolean	Acceptable to publicly share the content
Slices for component		0..*	See content (ArtifactAssessment)	Comment, classifier, or rating content Slice: Unordered, Open by value:type
component:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary		0..1	markdown	Brief summary of the content
type		0..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example)
classifier		0..*	CodeableConcept	Rating, classifier, or assessment Binding: EvidenceCertaintyRating (example)
quantity		0..1	Quantity	Quantitative rating
author		0..*	Reference(Patient | Practitioner | PractitionerRole | Organization | Device)	Who authored the content
path		0..*	uri	What the comment is directed to
relatesTo		0..*	See relatesTo (ArtifactAssessment)	Relationship to other Resources
freeToShare		0..1	boolean	Acceptable to publicly share the content
component		0..*	See content (ArtifactAssessment)	Comment, classifier, or rating content
component:ratingSystem		0..1	BackboneElement	Comment, classifier, or rating content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary		0..1	markdown	Brief summary of the content
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: rating-system
display		1..1	string	Representation defined by the system Fixed Value: Rating System
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
classifier		1..1	CodeableConcept	Rating, classifier, or assessment Binding: Evidence Rating System Value Set (preferred)
quantity		0..1	Quantity	Quantitative rating
author		0..*	Reference(Patient | Practitioner | PractitionerRole | Organization | Device)	Who authored the content
path		0..*	uri	What the comment is directed to
relatesTo		0..*	See relatesTo (ArtifactAssessment)	Relationship to other Resources
freeToShare		0..1	boolean	Acceptable to publicly share the content
component		0..*	See content (ArtifactAssessment)	Comment, classifier, or rating content
component:strengthOfRecommendation		0..1	BackboneElement	Comment, classifier, or rating content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary		0..1	markdown	Brief summary of the content
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: strength-of-recommendation
display		1..1	string	Representation defined by the system Fixed Value: Strength of Recommendation
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
classifier		0..*	CodeableConcept	Rating, classifier, or assessment Binding: EvidenceCertaintyRating (example)
quantity		0..1	Quantity	Quantitative rating
author		0..*	Reference(Patient | Practitioner | PractitionerRole | Organization | Device)	Who authored the content
path		0..*	uri	What the comment is directed to
relatesTo		0..*	See relatesTo (ArtifactAssessment)	Relationship to other Resources
freeToShare		0..1	boolean	Acceptable to publicly share the content
component		0..*	See content (ArtifactAssessment)	Comment, classifier, or rating content
component:directionOfRecommendation		0..1	BackboneElement	Comment, classifier, or rating content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary		0..1	markdown	Brief summary of the content
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: direction-of-recommendation
display		1..1	string	Representation defined by the system Fixed Value: Direction of Recommendation
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
classifier		1..1	CodeableConcept	​Rating, classifier, or assessment Binding: http://hl7.org/fhir/uv/cpg/ValueSet/cpg-recommendation-direction-vs (required)
quantity		0..1	Quantity	Quantitative rating
author		0..*	Reference(Patient | Practitioner | PractitionerRole | Organization | Device)	Who authored the content
path		0..*	uri	What the comment is directed to
relatesTo		0..*	See relatesTo (ArtifactAssessment)	Relationship to other Resources
freeToShare		0..1	boolean	Acceptable to publicly share the content
component		0..*	See content (ArtifactAssessment)	Comment, classifier, or rating content
component:levelOfConsensus		0..1	BackboneElement	Comment, classifier, or rating content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary		0..1	markdown	Brief summary of the content
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.awmf.org/awmf.ig/CodeSystem/cs-awmf
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: level-of-consensus
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
classifier		1..1	CodeableConcept	Rating, classifier, or assessment Binding: Level Of Consensus (required)
quantity		0..1	Quantity	Quantitative rating
author		0..*	Reference(Patient | Practitioner | PractitionerRole | Organization | Device)	Who authored the content
path		0..*	uri	What the comment is directed to
relatesTo		0..*	See relatesTo (ArtifactAssessment)	Relationship to other Resources
freeToShare		0..1	boolean	Acceptable to publicly share the content
component		0..*	See content (ArtifactAssessment)	Comment, classifier, or rating content
content:searchStrategy		0..1	BackboneElement	Comment, classifier, or rating content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary		0..1	markdown	Brief summary of the content
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SearchStrategy
display		1..1	string	Representation defined by the system Fixed Value: SearchStrategy
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
classifier		0..*	CodeableConcept	Rating, classifier, or assessment Binding: EvidenceCertaintyRating (example)
quantity		0..1	Quantity	Quantitative rating
author		0..*	Reference(Patient | Practitioner | PractitionerRole | Organization | Device)	Who authored the content
path		0..*	uri	What the comment is directed to
relatesTo		1..1	BackboneElement	Relationship to other Resources
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	code	documentation | justification | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | specification-of | created-with | cite-as | summarizes Binding: ArtifactRelationshipType (required): The type of relationship to the related artifact.
Slices for target[x]		1..1	Reference(Resource)	The artifact that is related to this ArtifactAssessment Slice: Unordered, Closed by type:$this
target[x]:targetReference		1..1	Reference(SystematicReview)	The artifact that is related to this ArtifactAssessment
freeToShare		0..1	boolean	Acceptable to publicly share the content
component		0..*	See content (ArtifactAssessment)	Comment, classifier, or rating content
content:evidence		0..*	BackboneElement	Comment, classifier, or rating content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary		0..1	markdown	Brief summary of the content
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: evidence
display		1..1	string	Representation defined by the system Fixed Value: Evidence
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
classifier		0..*	CodeableConcept	Rating, classifier, or assessment Binding: EvidenceCertaintyRating (example)
quantity		0..1	Quantity	Quantitative rating
author		0..*	Reference(Patient | Practitioner | PractitionerRole | Organization | Device)	Who authored the content
path		0..*	uri	What the comment is directed to
relatesTo		1..1	BackboneElement	Relationship to other Resources
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	code	documentation | justification | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | specification-of | created-with | cite-as | summarizes Binding: ArtifactRelationshipType (required): The type of relationship to the related artifact. Required Pattern: justification
Slices for target[x]		1..1	Reference(Resource)	The artifact that is related to this ArtifactAssessment Slice: Unordered, Closed by type:$this
target[x]:targetReference		1..1	Reference(Certainty of Evidence Rating)	The artifact that is related to this ArtifactAssessment
freeToShare		0..1	boolean	Acceptable to publicly share the content
component		0..*	BackboneElement	Comment, classifier, or rating content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary		0..1	markdown	Brief summary of the content
type		1..1	CodeableConcept	What type of content Binding: EvidenceCertaintyType (example) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fevir.net/resources/CodeSystem/179423
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: evidence
display		1..1	string	Representation defined by the system Fixed Value: Evidence
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
classifier		0..*	CodeableConcept	Rating, classifier, or assessment Binding: EvidenceCertaintyRating (example)
quantity		0..1	Quantity	Quantitative rating
author		0..*	Reference(Patient | Practitioner | PractitionerRole | Organization | Device)	Who authored the content
path		0..*	uri	What the comment is directed to
relatesTo		1..1	BackboneElement	Relationship to other Resources
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	code	documentation | justification | predecessor | successor | derived-from | depends-on | composed-of | part-of | amends | amended-with | appends | appended-with | cites | cited-by | comments-on | comment-in | contains | contained-in | corrects | correction-in | replaces | replaced-with | retracts | retracted-by | signs | similar-to | supports | supported-with | transforms | transformed-into | transformed-with | specification-of | created-with | cite-as | summarizes Binding: ArtifactRelationshipType (required): The type of relationship to the related artifact.
Slices for target[x]		1..1	Reference(Resource)	The artifact that is related to this ArtifactAssessment Slice: Unordered, Closed by type:$this
target[x]:targetReference		1..1	Reference(Certainty of Evidence Rating)	The artifact that is related to this ArtifactAssessment
freeToShare		0..1	boolean	Acceptable to publicly share the content
component		0..*	See content (ArtifactAssessment)	Comment, classifier, or rating content
workflowStatus	Σ	1..1	code	submitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published | entered-in-error Binding: ArtifactAssessmentWorkflowStatus (required) Required Pattern: applied
disposition	Σ	0..1	code	unresolved | not-persuasive | persuasive | persuasive-with-modification | not-persuasive-with-modification Binding: ArtifactAssessmentDisposition (required)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ArtifactAssessment.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot3 From the FHIR Standard
ArtifactAssessment.relatesTo.type	required	ArtifactRelationshipType http://hl7.org/fhir/ValueSet/artifact-relationship-type|6.0.0-ballot3 From the FHIR Standard
ArtifactAssessment.content.type	example	EvidenceCertaintyType http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content.classifier	example	EvidenceCertaintyRating http://hl7.org/fhir/ValueSet/certainty-rating From the FHIR Standard
ArtifactAssessment.content:recommendationRating.type	example	Pattern Value: recommendation-rating("Recommendation Rating") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:recommendationRating.classifier	example	EvidenceCertaintyRating http://hl7.org/fhir/ValueSet/certainty-rating From the FHIR Standard
ArtifactAssessment.content:recommendationRating.component.type	example	EvidenceCertaintyType http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:recommendationRating.component.classifier	example	EvidenceCertaintyRating http://hl7.org/fhir/ValueSet/certainty-rating From the FHIR Standard
ArtifactAssessment.content:recommendationRating.component:ratingSystem.type	example	Pattern Value: rating-system("Rating System") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:recommendationRating.component:ratingSystem.classifier	preferred	EvidenceRatingSystemVS(a valid code from Evidence Rating System Code System) http://fhir.awmf.org/awmf.ig/ValueSet/vs-evidence-rating-system From this IG
ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.type	example	Pattern Value: strength-of-recommendation("Strength of Recommendation") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.classifier	example	EvidenceCertaintyRating http://hl7.org/fhir/ValueSet/certainty-rating From the FHIR Standard
ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.type	example	Pattern Value: direction-of-recommendation("Direction of Recommendation") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.classifier	required	​http://hl7.org/fhir/uv/cpg/ValueSet/cpg-recommendation-direction-vs http://hl7.org/fhir/uv/cpg/ValueSet/cpg-recommendation-direction-vs
ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.type	example	Pattern Value: level-of-consensus http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.classifier	required	LevelOfConsensusVS(a valid code from Level of Consensus) http://fhir.awmf.org/awmf.ig/ValueSet/vs-level-of-consensus From this IG
ArtifactAssessment.content:searchStrategy.type	example	Pattern Value: SearchStrategy("SearchStrategy") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:searchStrategy.classifier	example	EvidenceCertaintyRating http://hl7.org/fhir/ValueSet/certainty-rating From the FHIR Standard
ArtifactAssessment.content:searchStrategy.relatesTo.type	required	ArtifactRelationshipType http://hl7.org/fhir/ValueSet/artifact-relationship-type|6.0.0-ballot3 From the FHIR Standard
ArtifactAssessment.content:evidence.type	example	Pattern Value: evidence("Evidence") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:evidence.classifier	example	EvidenceCertaintyRating http://hl7.org/fhir/ValueSet/certainty-rating From the FHIR Standard
ArtifactAssessment.content:evidence.relatesTo.type	required	Pattern Value: justification http://hl7.org/fhir/ValueSet/artifact-relationship-type|6.0.0-ballot3 From the FHIR Standard
ArtifactAssessment.content:evidence.component.type	example	Pattern Value: evidence("Evidence") http://hl7.org/fhir/ValueSet/certainty-type From the FHIR Standard
ArtifactAssessment.content:evidence.component.classifier	example	EvidenceCertaintyRating http://hl7.org/fhir/ValueSet/certainty-rating From the FHIR Standard
ArtifactAssessment.content:evidence.component.relatesTo.type	required	ArtifactRelationshipType http://hl7.org/fhir/ValueSet/artifact-relationship-type|6.0.0-ballot3 From the FHIR Standard
ArtifactAssessment.workflowStatus	required	Pattern Value: applied http://hl7.org/fhir/ValueSet/artifactassessment-workflow-status|6.0.0-ballot3 From the FHIR Standard
ArtifactAssessment.disposition	required	ArtifactAssessmentDisposition http://hl7.org/fhir/ValueSet/artifactassessment-disposition|6.0.0-ballot3 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	ArtifactAssessment	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ArtifactAssessment	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ArtifactAssessment	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ArtifactAssessment	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ArtifactAssessment	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())