Dissolve-E: AWMF Guideline Registry
0.2.0 - ci-build

Dissolve-E: AWMF Guideline Registry - Local Development build (v0.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: RecommendationJustificationSIGN - XML Profile

Draft as of 2026-01-29

XML representation of the recommendation-justification-sign resource profile.

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    <StructureDefinition xmlns="http://hl7.org/fhir">
      <id value="recommendation-justification-sign"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition recommendation-justification-sign</b></p><a name="recommendation-justification-sign"> </a><a name="hcrecommendation-justification-sign"> </a><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px; width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-recommendation-justification-sign-definitions.html#ArtifactAssessment">ArtifactAssessment</a><a name="ArtifactAssessment"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="StructureDefinition-recommendation-justification.html">RecommendationJustification</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Adds metadata-supported comments, classifiers or ratings related to a Resource</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck03.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Definition" class="hierarchy"/> Slices for content<a name="ArtifactAssessment.content"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Content/Rules for all slices</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck025.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-recommendation-justification-sign-definitions.html#ArtifactAssessment.content:evidenceRating" title="Slice evidenceRating">content:evidenceRating</a><a name="ArtifactAssessment.content.2"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; opacity: 0.5" href="http://hl7.org/fhir/R5/types.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Comment, classifier, or rating content</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0243.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Definition" class="hierarchy"/> Slices for component<a name="ArtifactAssessment.content.component"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Content/Rules for all slices</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck02435.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-recommendation-justification-sign-definitions.html#ArtifactAssessment.content:evidenceRating.component:ratingSystem" title="Slice ratingSystem">component:ratingSystem</a><a name="ArtifactAssessment.content.component.2"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; opacity: 0.5" href="http://hl7.org/fhir/R5/types.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Comment, classifier, or rating content</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck024341.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-recommendation-justification-sign-definitions.html#ArtifactAssessment.content:evidenceRating.component:ratingSystem.classifier">classifier</a><a name="ArtifactAssessment.content.component.classifier"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; opacity: 0.5" href="http://hl7.org/fhir/R5/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Rating, classifier, or assessment</span><br/><span style="font-weight:bold">Required Pattern: </span><span style="color: darkgreen">At least the following</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0243401.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_fixed.gif" alt="." style="background-color: white; background-color: inherit" title="Fixed Value" class="hierarchy"/> <a href="http://hl7.org/fhir/R5/datatypes-definitions.html#CodeableConcept.coding">coding</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#Coding">Coding</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Code defined by a terminology system<br/><span style="font-weight: bold">Fixed Value: </span><span style="color: darkgreen">(Complex)</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck02434010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_fixed.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Fixed Value" class="hierarchy"/> <a href="http://hl7.org/fhir/R5/datatypes-definitions.html#Coding.system">system</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Identity of the terminology system<br/><span style="font-weight: bold">Fixed Value: </span><span style="color: darkgreen">http://hl7.org/fhir/uv/ebm/CodeSystem/evidence-rating-system-classifier-codesystem</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck02434010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_fixed.gif" alt="." style="background-color: white; background-color: inherit" title="Fixed Value" class="hierarchy"/> <a href="http://hl7.org/fhir/R5/datatypes-definitions.html#Coding.code">code</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Symbol in syntax defined by the system<br/><span style="font-weight: bold">Fixed Value: </span><span style="color: darkgreen">SIGN</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck02434000.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_fixed.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Fixed Value" class="hierarchy"/> <a href="http://hl7.org/fhir/R5/datatypes-definitions.html#Coding.display">display</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Representation defined by the system<br/><span style="font-weight: bold">Fixed Value: </span><span style="color: darkgreen">SIGN</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck02425.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-recommendation-justification-sign-definitions.html#ArtifactAssessment.content:evidenceRating.component:levelOfEvidence" title="Slice levelOfEvidence">component:levelOfEvidence</a><a name="ArtifactAssessment.content.component.3"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; opacity: 0.5" href="http://hl7.org/fhir/R5/types.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Comment, classifier, or rating content</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck024240.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-recommendation-justification-sign-definitions.html#ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.classifier">classifier</a><a name="ArtifactAssessment.content.component.classifier.2"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; opacity: 0.5" href="http://hl7.org/fhir/R5/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Rating, classifier, or assessment</span><br class="binding"/><span style="font-weight:bold" title="null" class="binding">Binding: </span><a href="ValueSet-vs-sign-level-of-evidence.html" title="http://fhir.awmf.org/awmf.ig/ValueSet/vs-sign-level-of-evidence" class="binding">SIGN Level of Evidence Value Set</a><span title="null" class="binding"> (</span><a href="http://hl7.org/fhir/R5/terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability purposes but are not required to do so to be considered conformant." class="binding">preferred</a><span title="null" class="binding">)</span></td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
      </text>
      <url
           value="http://fhir.awmf.org/awmf.ig/StructureDefinition/recommendation-justification-sign"/>
      <version value="0.2.0"/>
      <name value="RecommendationJustificationSIGN"/>
      <title value="Recommendation Justification SIGN"/>
      <status value="draft"/>
      <date value="2026-01-29T18:27:10+00:00"/>
      <publisher value="AWMF e.V."/>
      <contact>
        <name value="AWMF e.V."/>
        <telecom>
          <system value="url"/>
          <value value="https://www.awmf.org"/>
        </telecom>
      </contact>
      <description
                   value="A structured assessment of the evidence and consensus that underpins a recommendation using the SIGN evidence rating system."/>
      <fhirVersion value="6.0.0-ballot3"/>
      <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>
      <mapping>
        <identity value="objimpl"/>
        <uri value="http://hl7.org/fhir/object-implementation"/>
        <name value="Object Implementation Information"/>
      </mapping>
      <kind value="resource"/>
      <abstract value="false"/>
      <type value="ArtifactAssessment"/>
      <baseDefinition
                      value="http://fhir.awmf.org/awmf.ig/StructureDefinition/recommendation-justification"/>
      <derivation value="constraint"/>
      <snapshot>
        <extension
                   url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
          <valueString value="0.2.0"/>
        </extension>
        <element id="ArtifactAssessment">
          <path value="ArtifactAssessment"/>
          <short
                 value="Adds metadata-supported comments, classifiers or ratings related to a Resource"/>
          <definition
                      value="This Resource provides one or more comments, classifiers or ratings about a Resource and supports attribution and rights management metadata for the added content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <constraint>
            <key value="dom-2"/>
            <severity value="error"/>
            <human
                   value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
            <expression value="contained.contained.empty()"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-3"/>
            <severity value="error"/>
            <human
                   value="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"/>
            <expression
                        value="contained.where((('#'+id.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty()"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-4"/>
            <severity value="error"/>
            <human
                   value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
            <expression
                        value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-5"/>
            <severity value="error"/>
            <human
                   value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
            <expression value="contained.meta.security.empty()"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
              <valueBoolean value="true"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
              <valueMarkdown
                             value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
            </extension>
            <key value="dom-6"/>
            <severity value="warning"/>
            <human
                   value="A resource should have narrative for robust management"/>
            <expression value="text.`div`.exists()"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="Entity, Role, or Act,Act[classCode=ACT; moodCode=DEFN]"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="clinical.general"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.id">
          <path value="ArtifactAssessment.id"/>
          <short value="Logical id of this artifact"/>
          <definition
                      value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
          <comment
                   value="Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="id"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="ArtifactAssessment.meta">
          <path value="ArtifactAssessment.meta"/>
          <short value="Metadata about the resource"/>
          <definition
                      value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.meta"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Meta"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="ArtifactAssessment.implicitRules">
          <path value="ArtifactAssessment.implicitRules"/>
          <short value="A set of rules under which this content was created"/>
          <definition
                      value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc."/>
          <comment
                   value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.implicitRules"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="true"/>
          <isModifierReason
                            value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation"/>
          <isSummary value="true"/>
        </element>
        <element id="ArtifactAssessment.language">
          <path value="ArtifactAssessment.language"/>
          <short value="Language of the resource content"/>
          <definition
                      value="The base language in which the resource is written."/>
          <comment
                   value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.language"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="Language"/>
            </extension>
            <strength value="required"/>
            <description value="IETF language tag for a human language"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot3"/>
            <additional>
              <purpose value="starter"/>
              <valueSet
                        value="http://hl7.org/fhir/ValueSet/languages|6.0.0-ballot3"/>
            </additional>
          </binding>
        </element>
        <element id="ArtifactAssessment.text">
          <path value="ArtifactAssessment.text"/>
          <short value="Text summary of the resource, for human interpretation"/>
          <definition
                      value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
          <comment
                   value="Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later."/>
          <alias value="narrative"/>
          <alias value="html"/>
          <alias value="xhtml"/>
          <alias value="display"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="DomainResource.text"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Narrative"/>
          </type>
          <condition value="dom-6"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="Act.text?"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.contained">
          <path value="ArtifactAssessment.contained"/>
          <short value="Contained, inline Resources"/>
          <definition
                      value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning."/>
          <comment
                   value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels. Contained resources may be a resource type defined in the FHIR specification, or an [additional resource](http://build.fhir.org/resource.html#additional)."/>
          <alias value="inline resources"/>
          <alias value="anonymous resources"/>
          <alias value="contained resources"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.contained"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Resource"/>
          </type>
          <condition value="dom-2"/>
          <condition value="dom-4"/>
          <condition value="dom-3"/>
          <condition value="dom-5"/>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.extension">
          <path value="ArtifactAssessment.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.modifierExtension">
          <path value="ArtifactAssessment.modifierExtension"/>
          <short value="Extensions that cannot be ignored"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.identifier">
          <path value="ArtifactAssessment.identifier"/>
          <short value="Additional identifier for the artifact assessment"/>
          <definition
                      value="A formal identifier that is used to identify this artifact assessment when it is represented in other formats, or referenced in a specification, model, design or an instance."/>
          <comment
                   value="This may be used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this artifact assessment 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 artifact assessment."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.identifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Identifier"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.identifier"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".identifier"/>
          </mapping>
          <mapping>
            <identity value="objimpl"/>
            <map value="no-gen-base"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.title">
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
            <valueBoolean value="true"/>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
            <valueBoolean value="true"/>
          </extension>
          <path value="ArtifactAssessment.title"/>
          <short
                 value="A label for use in displaying and selecting the artifact assessment"/>
          <definition
                      value="A label for use in displaying and selecting the artifact assessment."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.title"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="ArtifactAssessment.citeAs">
          <path value="ArtifactAssessment.citeAs"/>
          <short value="How to cite the comment or rating"/>
          <definition
                      value="Display of the bibliographic citation of the comment, classifier, or rating."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.citeAs"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.artifact[x]">
          <path value="ArtifactAssessment.artifact[x]"/>
          <slicing>
            <discriminator>
              <type value="type"/>
              <path value="$this"/>
            </discriminator>
            <ordered value="false"/>
            <rules value="open"/>
          </slicing>
          <short value="The artifact assessed, commented upon or rated"/>
          <definition
                      value="A reference to a resource, canonical resource, or non-FHIR resource which the comment or assessment is about."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.artifact[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Resource|6.0.0-ballot3"/>
          </type>
          <type>
            <code value="canonical"/>
          </type>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.what[x]"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.artifact[x]:artifactReference">
          <path value="ArtifactAssessment.artifact[x]"/>
          <sliceName value="artifactReference"/>
          <short value="The artifact assessed, commented upon or rated"/>
          <definition
                      value="A reference to a resource, canonical resource, or non-FHIR resource which the comment or assessment is about."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.artifact[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://fhir.awmf.org/awmf.ig/StructureDefinition/recommendation"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.what[x]"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.relatesTo">
          <path value="ArtifactAssessment.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this ArtifactAssessment has with other FHIR or non-FHIR resources that already exist."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human
                   value="All FHIR elements must have a @value or children or both"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.relatesTo.id">
          <path value="ArtifactAssessment.relatesTo.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.relatesTo.extension">
          <path value="ArtifactAssessment.relatesTo.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.relatesTo.modifierExtension">
          <path value="ArtifactAssessment.relatesTo.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.relatesTo.type">
          <path value="ArtifactAssessment.relatesTo.type"/>
          <short
                 value="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"/>
          <definition value="The type of relationship to the related artifact."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.relatesTo.type"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ArtifactRelationshipType"/>
            </extension>
            <strength value="required"/>
            <description
                         value="The type of relationship to the related artifact."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/artifact-relationship-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element id="ArtifactAssessment.relatesTo.target[x]">
          <path value="ArtifactAssessment.relatesTo.target[x]"/>
          <short value="The artifact that is related to this ArtifactAssessment"/>
          <definition
                      value="The artifact that is related to this ArtifactAssessment Resource."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.relatesTo.target[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <type>
            <code value="Attachment"/>
          </type>
          <type>
            <code value="canonical"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Resource|6.0.0-ballot3"/>
          </type>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Resource|6.0.0-ballot3"/>
          </type>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.date">
          <path value="ArtifactAssessment.date"/>
          <short value="Date last changed"/>
          <definition
                      value="The date  (and optionally time) when the artifact assessment was published. The date must change when the disposition changes and it must change if the workflow status code changes. In addition, it should change when the substantive content of the artifact assessment changes."/>
          <comment
                   value="The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the artifact assessment. 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"/>
          <base>
            <path value="ArtifactAssessment.date"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="dateTime"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.recorded"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".participation[typeCode=AUT].time"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.copyright">
          <path value="ArtifactAssessment.copyright"/>
          <short value="Use and/or publishing restrictions"/>
          <definition
                      value="A copyright statement relating to the artifact assessment and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the artifact assessment."/>
          <requirements
                        value="Consumers must be able to determine any legal restrictions on the use of the artifact assessment and/or its content."/>
          <alias value="License"/>
          <alias value="Restrictions"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.copyright"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A (to add?)"/>
          </mapping>
          <mapping>
            <identity value="objimpl"/>
            <map value="no-gen-base"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.approvalDate">
          <path value="ArtifactAssessment.approvalDate"/>
          <short value="When the artifact assessment 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"/>
          <base>
            <path value="ArtifactAssessment.approvalDate"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="date"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".outboundRelationship[typeCode=&quot;SUBJ&quot;].act[classCode=CACT;moodCode=EVN;code=&quot;approval&quot;].effectiveTime"/>
          </mapping>
          <mapping>
            <identity value="objimpl"/>
            <map value="no-gen-base"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.lastReviewDate">
          <path value="ArtifactAssessment.lastReviewDate"/>
          <short
                 value="When the artifact assessment was last reviewed by the publisher"/>
          <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"/>
          <base>
            <path value="ArtifactAssessment.lastReviewDate"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="date"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".outboundRelationship[typeCode=&quot;SUBJ&quot;; subsetCode=&quot;RECENT&quot;].act[classCode=CACT;moodCode=EVN;code=&quot;review&quot;].effectiveTime"/>
          </mapping>
          <mapping>
            <identity value="objimpl"/>
            <map value="no-gen-base"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.content">
          <path value="ArtifactAssessment.content"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="type"/>
            </discriminator>
            <rules value="open"/>
          </slicing>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human
                   value="All FHIR elements must have a @value or children or both"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content.id">
          <path value="ArtifactAssessment.content.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.content.extension">
          <path value="ArtifactAssessment.content.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.content.modifierExtension">
          <path value="ArtifactAssessment.content.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.content.summary">
          <path value="ArtifactAssessment.content.summary"/>
          <short value="Brief summary of the content"/>
          <definition value="A brief summary of the content of this component."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.summary"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content.type">
          <path value="ArtifactAssessment.content.type"/>
          <short value="What type of content"/>
          <definition
                      value="Indicates what type of content this component represents."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyType"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element id="ArtifactAssessment.content.classifier">
          <path value="ArtifactAssessment.content.classifier"/>
          <short value="Rating, classifier, or assessment"/>
          <definition
                      value="Represents a rating, classifier, or assessment of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.classifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyRating"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-rating|6.0.0-ballot3"/>
          </binding>
        </element>
        <element id="ArtifactAssessment.content.quantity">
          <path value="ArtifactAssessment.content.quantity"/>
          <short value="Quantitative rating"/>
          <definition value="A quantitative rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content.author">
          <path value="ArtifactAssessment.content.author"/>
          <short value="Who authored the content"/>
          <definition value="Indicates who or what authored the content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.author"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content.path">
          <path value="ArtifactAssessment.content.path"/>
          <short value="What the comment is directed to"/>
          <definition
                      value="A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource."/>
          <comment
                   value="The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.path"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content.relatesTo">
          <path value="ArtifactAssessment.content.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this content component has with other FHIR or non-FHIR resources that already exist."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.relatesTo"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content.freeToShare">
          <path value="ArtifactAssessment.content.freeToShare"/>
          <short value="Acceptable to publicly share the content"/>
          <definition
                      value="Acceptable to publicly share the comment, classifier or rating."/>
          <comment
                   value="Absence of a value should be interpreted as inheriting any freeToShare value present in a containing structure, else inheriting data from the ArtifactAssessment.copyright element, else value unknown."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.freeToShare"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content.component">
          <path value="ArtifactAssessment.content.component"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:recommendationRating">
          <path value="ArtifactAssessment.content"/>
          <sliceName value="recommendationRating"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human
                   value="All FHIR elements must have a @value or children or both"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:recommendationRating.id">
          <path value="ArtifactAssessment.content.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.content:recommendationRating.extension">
          <path value="ArtifactAssessment.content.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.modifierExtension">
          <path value="ArtifactAssessment.content.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.content:recommendationRating.summary">
          <path value="ArtifactAssessment.content.summary"/>
          <short value="Brief summary of the content"/>
          <definition value="A brief summary of the content of this component."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.summary"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:recommendationRating.type">
          <path value="ArtifactAssessment.content.type"/>
          <short value="What type of content"/>
          <definition
                      value="Indicates what type of content this component represents."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <patternCodeableConcept>
            <coding>
              <system value="https://fevir.net/resources/CodeSystem/179423"/>
              <code value="recommendation-rating"/>
              <display value="Recommendation Rating"/>
            </coding>
          </patternCodeableConcept>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyType"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element id="ArtifactAssessment.content:recommendationRating.classifier">
          <path value="ArtifactAssessment.content.classifier"/>
          <short value="Rating, classifier, or assessment"/>
          <definition
                      value="Represents a rating, classifier, or assessment of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.classifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyRating"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-rating|6.0.0-ballot3"/>
          </binding>
        </element>
        <element id="ArtifactAssessment.content:recommendationRating.quantity">
          <path value="ArtifactAssessment.content.quantity"/>
          <short value="Quantitative rating"/>
          <definition value="A quantitative rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:recommendationRating.author">
          <path value="ArtifactAssessment.content.author"/>
          <short value="Who authored the content"/>
          <definition value="Indicates who or what authored the content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.author"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:recommendationRating.path">
          <path value="ArtifactAssessment.content.path"/>
          <short value="What the comment is directed to"/>
          <definition
                      value="A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource."/>
          <comment
                   value="The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.path"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:recommendationRating.relatesTo">
          <path value="ArtifactAssessment.content.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this content component has with other FHIR or non-FHIR resources that already exist."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.relatesTo"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.freeToShare">
          <path value="ArtifactAssessment.content.freeToShare"/>
          <short value="Acceptable to publicly share the content"/>
          <definition
                      value="Acceptable to publicly share the comment, classifier or rating."/>
          <comment
                   value="Absence of a value should be interpreted as inheriting any freeToShare value present in a containing structure, else inheriting data from the ArtifactAssessment.copyright element, else value unknown."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.freeToShare"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:recommendationRating.component">
          <path value="ArtifactAssessment.content.component"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="type"/>
            </discriminator>
            <rules value="open"/>
          </slicing>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component.id">
          <path value="ArtifactAssessment.content.component.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component.extension">
          <path value="ArtifactAssessment.content.component.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component.modifierExtension">
          <path value="ArtifactAssessment.content.component.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component.summary">
          <path value="ArtifactAssessment.content.component.summary"/>
          <short value="Brief summary of the content"/>
          <definition value="A brief summary of the content of this component."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.summary"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component.type">
          <path value="ArtifactAssessment.content.component.type"/>
          <short value="What type of content"/>
          <definition
                      value="Indicates what type of content this component represents."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyType"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component.classifier">
          <path value="ArtifactAssessment.content.component.classifier"/>
          <short value="Rating, classifier, or assessment"/>
          <definition
                      value="Represents a rating, classifier, or assessment of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.classifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyRating"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-rating|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component.quantity">
          <path value="ArtifactAssessment.content.component.quantity"/>
          <short value="Quantitative rating"/>
          <definition value="A quantitative rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component.author">
          <path value="ArtifactAssessment.content.component.author"/>
          <short value="Who authored the content"/>
          <definition value="Indicates who or what authored the content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.author"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component.path">
          <path value="ArtifactAssessment.content.component.path"/>
          <short value="What the comment is directed to"/>
          <definition
                      value="A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource."/>
          <comment
                   value="The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.path"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component.relatesTo">
          <path value="ArtifactAssessment.content.component.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this content component has with other FHIR or non-FHIR resources that already exist."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.relatesTo"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component.freeToShare">
          <path value="ArtifactAssessment.content.component.freeToShare"/>
          <short value="Acceptable to publicly share the content"/>
          <definition
                      value="Acceptable to publicly share the comment, classifier or rating."/>
          <comment
                   value="Absence of a value should be interpreted as inheriting any freeToShare value present in a containing structure, else inheriting data from the ArtifactAssessment.copyright element, else value unknown."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.freeToShare"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component.component">
          <path value="ArtifactAssessment.content.component.component"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:ratingSystem">
          <path value="ArtifactAssessment.content.component"/>
          <sliceName value="ratingSystem"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:ratingSystem.id">
          <path value="ArtifactAssessment.content.component.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:ratingSystem.extension">
          <path value="ArtifactAssessment.content.component.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:ratingSystem.modifierExtension">
          <path value="ArtifactAssessment.content.component.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:ratingSystem.summary">
          <path value="ArtifactAssessment.content.component.summary"/>
          <short value="Brief summary of the content"/>
          <definition value="A brief summary of the content of this component."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.summary"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:ratingSystem.type">
          <path value="ArtifactAssessment.content.component.type"/>
          <short value="What type of content"/>
          <definition
                      value="Indicates what type of content this component represents."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <patternCodeableConcept>
            <coding>
              <system value="https://fevir.net/resources/CodeSystem/179423"/>
              <code value="rating-system"/>
              <display value="Rating System"/>
            </coding>
          </patternCodeableConcept>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyType"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:ratingSystem.classifier">
          <path value="ArtifactAssessment.content.component.classifier"/>
          <short value="Rating, classifier, or assessment"/>
          <definition
                      value="Represents a rating, classifier, or assessment of the artifact."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.classifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <strength value="preferred"/>
            <valueSet
                      value="http://hl7.org/fhir/uv/ebm/ValueSet/evidence-rating-system-classifier"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:ratingSystem.quantity">
          <path value="ArtifactAssessment.content.component.quantity"/>
          <short value="Quantitative rating"/>
          <definition value="A quantitative rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:ratingSystem.author">
          <path value="ArtifactAssessment.content.component.author"/>
          <short value="Who authored the content"/>
          <definition value="Indicates who or what authored the content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.author"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:ratingSystem.path">
          <path value="ArtifactAssessment.content.component.path"/>
          <short value="What the comment is directed to"/>
          <definition
                      value="A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource."/>
          <comment
                   value="The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.path"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:ratingSystem.relatesTo">
          <path value="ArtifactAssessment.content.component.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this content component has with other FHIR or non-FHIR resources that already exist."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.relatesTo"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:ratingSystem.freeToShare">
          <path value="ArtifactAssessment.content.component.freeToShare"/>
          <short value="Acceptable to publicly share the content"/>
          <definition
                      value="Acceptable to publicly share the comment, classifier or rating."/>
          <comment
                   value="Absence of a value should be interpreted as inheriting any freeToShare value present in a containing structure, else inheriting data from the ArtifactAssessment.copyright element, else value unknown."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.freeToShare"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:ratingSystem.component">
          <path value="ArtifactAssessment.content.component.component"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation">
          <path value="ArtifactAssessment.content.component"/>
          <sliceName value="strengthOfRecommendation"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.id">
          <path value="ArtifactAssessment.content.component.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.extension">
          <path value="ArtifactAssessment.content.component.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.modifierExtension">
          <path value="ArtifactAssessment.content.component.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.summary">
          <path value="ArtifactAssessment.content.component.summary"/>
          <short value="Brief summary of the content"/>
          <definition value="A brief summary of the content of this component."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.summary"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.type">
          <path value="ArtifactAssessment.content.component.type"/>
          <short value="What type of content"/>
          <definition
                      value="Indicates what type of content this component represents."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <patternCodeableConcept>
            <coding>
              <system value="https://fevir.net/resources/CodeSystem/179423"/>
              <code value="strength-of-recommendation"/>
              <display value="Strength of Recommendation"/>
            </coding>
          </patternCodeableConcept>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyType"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.classifier">
          <path value="ArtifactAssessment.content.component.classifier"/>
          <short value="Rating, classifier, or assessment"/>
          <definition
                      value="Represents a rating, classifier, or assessment of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.classifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyRating"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-rating|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.quantity">
          <path value="ArtifactAssessment.content.component.quantity"/>
          <short value="Quantitative rating"/>
          <definition value="A quantitative rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.author">
          <path value="ArtifactAssessment.content.component.author"/>
          <short value="Who authored the content"/>
          <definition value="Indicates who or what authored the content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.author"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.path">
          <path value="ArtifactAssessment.content.component.path"/>
          <short value="What the comment is directed to"/>
          <definition
                      value="A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource."/>
          <comment
                   value="The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.path"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.relatesTo">
          <path value="ArtifactAssessment.content.component.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this content component has with other FHIR or non-FHIR resources that already exist."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.relatesTo"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.freeToShare">
          <path value="ArtifactAssessment.content.component.freeToShare"/>
          <short value="Acceptable to publicly share the content"/>
          <definition
                      value="Acceptable to publicly share the comment, classifier or rating."/>
          <comment
                   value="Absence of a value should be interpreted as inheriting any freeToShare value present in a containing structure, else inheriting data from the ArtifactAssessment.copyright element, else value unknown."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.freeToShare"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:strengthOfRecommendation.component">
          <path value="ArtifactAssessment.content.component.component"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation">
          <path value="ArtifactAssessment.content.component"/>
          <sliceName value="directionOfRecommendation"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.id">
          <path value="ArtifactAssessment.content.component.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.extension">
          <path value="ArtifactAssessment.content.component.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.modifierExtension">
          <path value="ArtifactAssessment.content.component.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.summary">
          <path value="ArtifactAssessment.content.component.summary"/>
          <short value="Brief summary of the content"/>
          <definition value="A brief summary of the content of this component."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.summary"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.type">
          <path value="ArtifactAssessment.content.component.type"/>
          <short value="What type of content"/>
          <definition
                      value="Indicates what type of content this component represents."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <patternCodeableConcept>
            <coding>
              <system value="https://fevir.net/resources/CodeSystem/179423"/>
              <code value="direction-of-recommendation"/>
              <display value="Direction of Recommendation"/>
            </coding>
          </patternCodeableConcept>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyType"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.classifier">
          <path value="ArtifactAssessment.content.component.classifier"/>
          <short value="Rating, classifier, or assessment"/>
          <definition
                      value="Represents a rating, classifier, or assessment of the artifact."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.classifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <strength value="required"/>
            <valueSet
                      value="http://fhir.awmf.org/awmf.ig/ValueSet/vs-recommendation-direction"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.quantity">
          <path value="ArtifactAssessment.content.component.quantity"/>
          <short value="Quantitative rating"/>
          <definition value="A quantitative rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.author">
          <path value="ArtifactAssessment.content.component.author"/>
          <short value="Who authored the content"/>
          <definition value="Indicates who or what authored the content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.author"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.path">
          <path value="ArtifactAssessment.content.component.path"/>
          <short value="What the comment is directed to"/>
          <definition
                      value="A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource."/>
          <comment
                   value="The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.path"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.relatesTo">
          <path value="ArtifactAssessment.content.component.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this content component has with other FHIR or non-FHIR resources that already exist."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.relatesTo"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.freeToShare">
          <path value="ArtifactAssessment.content.component.freeToShare"/>
          <short value="Acceptable to publicly share the content"/>
          <definition
                      value="Acceptable to publicly share the comment, classifier or rating."/>
          <comment
                   value="Absence of a value should be interpreted as inheriting any freeToShare value present in a containing structure, else inheriting data from the ArtifactAssessment.copyright element, else value unknown."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.freeToShare"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:directionOfRecommendation.component">
          <path value="ArtifactAssessment.content.component.component"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:levelOfConsensus">
          <path value="ArtifactAssessment.content.component"/>
          <sliceName value="levelOfConsensus"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.id">
          <path value="ArtifactAssessment.content.component.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.extension">
          <path value="ArtifactAssessment.content.component.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.modifierExtension">
          <path value="ArtifactAssessment.content.component.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.summary">
          <path value="ArtifactAssessment.content.component.summary"/>
          <short value="Brief summary of the content"/>
          <definition value="A brief summary of the content of this component."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.summary"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.type">
          <path value="ArtifactAssessment.content.component.type"/>
          <short value="What type of content"/>
          <definition
                      value="Indicates what type of content this component represents."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <patternCodeableConcept>
            <coding>
              <system value="http://fhir.awmf.org/awmf.ig/CodeSystem/cs-awmf"/>
              <code value="level-of-consensus"/>
            </coding>
          </patternCodeableConcept>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyType"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.classifier">
          <path value="ArtifactAssessment.content.component.classifier"/>
          <short value="Rating, classifier, or assessment"/>
          <definition
                      value="Represents a rating, classifier, or assessment of the artifact."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.classifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <strength value="required"/>
            <valueSet
                      value="http://fhir.awmf.org/awmf.ig/ValueSet/vs-level-of-consensus"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.quantity">
          <path value="ArtifactAssessment.content.component.quantity"/>
          <short value="Quantitative rating"/>
          <definition value="A quantitative rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.author">
          <path value="ArtifactAssessment.content.component.author"/>
          <short value="Who authored the content"/>
          <definition value="Indicates who or what authored the content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.author"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.path">
          <path value="ArtifactAssessment.content.component.path"/>
          <short value="What the comment is directed to"/>
          <definition
                      value="A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource."/>
          <comment
                   value="The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.path"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.relatesTo">
          <path value="ArtifactAssessment.content.component.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this content component has with other FHIR or non-FHIR resources that already exist."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.relatesTo"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.freeToShare">
          <path value="ArtifactAssessment.content.component.freeToShare"/>
          <short value="Acceptable to publicly share the content"/>
          <definition
                      value="Acceptable to publicly share the comment, classifier or rating."/>
          <comment
                   value="Absence of a value should be interpreted as inheriting any freeToShare value present in a containing structure, else inheriting data from the ArtifactAssessment.copyright element, else value unknown."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.freeToShare"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:recommendationRating.component:levelOfConsensus.component">
          <path value="ArtifactAssessment.content.component.component"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:evidenceRating">
          <path value="ArtifactAssessment.content"/>
          <sliceName value="evidenceRating"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human
                   value="All FHIR elements must have a @value or children or both"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:evidenceRating.id">
          <path value="ArtifactAssessment.content.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.content:evidenceRating.extension">
          <path value="ArtifactAssessment.content.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.modifierExtension">
          <path value="ArtifactAssessment.content.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.content:evidenceRating.summary">
          <path value="ArtifactAssessment.content.summary"/>
          <short value="Brief summary of the content"/>
          <definition value="A brief summary of the content of this component."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.summary"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:evidenceRating.type">
          <path value="ArtifactAssessment.content.type"/>
          <short value="What type of content"/>
          <definition
                      value="Indicates what type of content this component represents."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <patternCodeableConcept>
            <coding>
              <system value="http://fhir.awmf.org/awmf.ig/CodeSystem/cs-awmf"/>
              <code value="evidence-rating"/>
              <display value="Evidence Rating"/>
            </coding>
          </patternCodeableConcept>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyType"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element id="ArtifactAssessment.content:evidenceRating.classifier">
          <path value="ArtifactAssessment.content.classifier"/>
          <short value="Rating, classifier, or assessment"/>
          <definition
                      value="Represents a rating, classifier, or assessment of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.classifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyRating"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-rating|6.0.0-ballot3"/>
          </binding>
        </element>
        <element id="ArtifactAssessment.content:evidenceRating.quantity">
          <path value="ArtifactAssessment.content.quantity"/>
          <short value="Quantitative rating"/>
          <definition value="A quantitative rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:evidenceRating.author">
          <path value="ArtifactAssessment.content.author"/>
          <short value="Who authored the content"/>
          <definition value="Indicates who or what authored the content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.author"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:evidenceRating.path">
          <path value="ArtifactAssessment.content.path"/>
          <short value="What the comment is directed to"/>
          <definition
                      value="A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource."/>
          <comment
                   value="The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.path"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:evidenceRating.relatesTo">
          <path value="ArtifactAssessment.content.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this content component has with other FHIR or non-FHIR resources that already exist."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.relatesTo"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:evidenceRating.freeToShare">
          <path value="ArtifactAssessment.content.freeToShare"/>
          <short value="Acceptable to publicly share the content"/>
          <definition
                      value="Acceptable to publicly share the comment, classifier or rating."/>
          <comment
                   value="Absence of a value should be interpreted as inheriting any freeToShare value present in a containing structure, else inheriting data from the ArtifactAssessment.copyright element, else value unknown."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.freeToShare"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:evidenceRating.component">
          <path value="ArtifactAssessment.content.component"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="type"/>
            </discriminator>
            <rules value="open"/>
          </slicing>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem">
          <path value="ArtifactAssessment.content.component"/>
          <sliceName value="ratingSystem"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem.id">
          <path value="ArtifactAssessment.content.component.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem.extension">
          <path value="ArtifactAssessment.content.component.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem.modifierExtension">
          <path value="ArtifactAssessment.content.component.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem.summary">
          <path value="ArtifactAssessment.content.component.summary"/>
          <short value="Brief summary of the content"/>
          <definition value="A brief summary of the content of this component."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.summary"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem.type">
          <path value="ArtifactAssessment.content.component.type"/>
          <short value="What type of content"/>
          <definition
                      value="Indicates what type of content this component represents."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <patternCodeableConcept>
            <coding>
              <system value="https://fevir.net/resources/CodeSystem/179423"/>
              <code value="rating-system"/>
              <display value="Rating System"/>
            </coding>
          </patternCodeableConcept>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyType"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem.classifier">
          <path value="ArtifactAssessment.content.component.classifier"/>
          <short value="Rating, classifier, or assessment"/>
          <definition
                      value="Represents a rating, classifier, or assessment of the artifact."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.classifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <patternCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/uv/ebm/CodeSystem/evidence-rating-system-classifier-codesystem"/>
              <code value="SIGN"/>
              <display value="SIGN"/>
            </coding>
          </patternCodeableConcept>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <strength value="extensible"/>
            <valueSet
                      value="http://hl7.org/fhir/uv/ebm/ValueSet/evidence-rating-system-classifier"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem.quantity">
          <path value="ArtifactAssessment.content.component.quantity"/>
          <short value="Quantitative rating"/>
          <definition value="A quantitative rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem.author">
          <path value="ArtifactAssessment.content.component.author"/>
          <short value="Who authored the content"/>
          <definition value="Indicates who or what authored the content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.author"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem.path">
          <path value="ArtifactAssessment.content.component.path"/>
          <short value="What the comment is directed to"/>
          <definition
                      value="A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource."/>
          <comment
                   value="The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.path"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem.relatesTo">
          <path value="ArtifactAssessment.content.component.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this content component has with other FHIR or non-FHIR resources that already exist."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.relatesTo"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem.freeToShare">
          <path value="ArtifactAssessment.content.component.freeToShare"/>
          <short value="Acceptable to publicly share the content"/>
          <definition
                      value="Acceptable to publicly share the comment, classifier or rating."/>
          <comment
                   value="Absence of a value should be interpreted as inheriting any freeToShare value present in a containing structure, else inheriting data from the ArtifactAssessment.copyright element, else value unknown."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.freeToShare"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem.component">
          <path value="ArtifactAssessment.content.component.component"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence">
          <path value="ArtifactAssessment.content.component"/>
          <sliceName value="levelOfEvidence"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.id">
          <path value="ArtifactAssessment.content.component.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.extension">
          <path value="ArtifactAssessment.content.component.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.modifierExtension">
          <path value="ArtifactAssessment.content.component.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.summary">
          <path value="ArtifactAssessment.content.component.summary"/>
          <short value="Brief summary of the content"/>
          <definition value="A brief summary of the content of this component."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.summary"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.type">
          <path value="ArtifactAssessment.content.component.type"/>
          <short value="What type of content"/>
          <definition
                      value="Indicates what type of content this component represents."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <patternCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/certainty-type"/>
              <code value="Overall"/>
              <display value="Overall certainty"/>
            </coding>
          </patternCodeableConcept>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyType"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.classifier">
          <path value="ArtifactAssessment.content.component.classifier"/>
          <short value="Rating, classifier, or assessment"/>
          <definition
                      value="Represents a rating, classifier, or assessment of the artifact."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.classifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <strength value="preferred"/>
            <valueSet
                      value="http://fhir.awmf.org/awmf.ig/ValueSet/vs-sign-level-of-evidence"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.quantity">
          <path value="ArtifactAssessment.content.component.quantity"/>
          <short value="Quantitative rating"/>
          <definition value="A quantitative rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.author">
          <path value="ArtifactAssessment.content.component.author"/>
          <short value="Who authored the content"/>
          <definition value="Indicates who or what authored the content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.author"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.path">
          <path value="ArtifactAssessment.content.component.path"/>
          <short value="What the comment is directed to"/>
          <definition
                      value="A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource."/>
          <comment
                   value="The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.path"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.relatesTo">
          <path value="ArtifactAssessment.content.component.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this content component has with other FHIR or non-FHIR resources that already exist."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.relatesTo"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.freeToShare">
          <path value="ArtifactAssessment.content.component.freeToShare"/>
          <short value="Acceptable to publicly share the content"/>
          <definition
                      value="Acceptable to publicly share the comment, classifier or rating."/>
          <comment
                   value="Absence of a value should be interpreted as inheriting any freeToShare value present in a containing structure, else inheriting data from the ArtifactAssessment.copyright element, else value unknown."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.freeToShare"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.component">
          <path value="ArtifactAssessment.content.component.component"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome">
          <path value="ArtifactAssessment.content.component"/>
          <sliceName value="outcome"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.id">
          <path value="ArtifactAssessment.content.component.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.extension">
          <path value="ArtifactAssessment.content.component.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.modifierExtension">
          <path value="ArtifactAssessment.content.component.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.summary">
          <path value="ArtifactAssessment.content.component.summary"/>
          <short value="Brief summary of the content"/>
          <definition value="A brief summary of the content of this component."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.summary"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.type">
          <path value="ArtifactAssessment.content.component.type"/>
          <short value="What type of content"/>
          <definition
                      value="Indicates what type of content this component represents."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <patternCodeableConcept>
            <coding>
              <system value="http://fhir.awmf.org/awmf.ig/CodeSystem/cs-pico"/>
              <code value="outcome"/>
              <display value="Outcome"/>
            </coding>
          </patternCodeableConcept>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyType"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.classifier">
          <path value="ArtifactAssessment.content.component.classifier"/>
          <short value="Rating, classifier, or assessment"/>
          <definition
                      value="Represents a rating, classifier, or assessment of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.classifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyRating"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-rating|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.quantity">
          <path value="ArtifactAssessment.content.component.quantity"/>
          <short value="Quantitative rating"/>
          <definition value="A quantitative rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.author">
          <path value="ArtifactAssessment.content.component.author"/>
          <short value="Who authored the content"/>
          <definition value="Indicates who or what authored the content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.author"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.path">
          <path value="ArtifactAssessment.content.component.path"/>
          <short value="What the comment is directed to"/>
          <definition
                      value="A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource."/>
          <comment
                   value="The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.path"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.relatesTo">
          <path value="ArtifactAssessment.content.component.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this content component has with other FHIR or non-FHIR resources that already exist."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.relatesTo.id">
          <path value="ArtifactAssessment.content.component.relatesTo.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.relatesTo.extension">
          <path value="ArtifactAssessment.content.component.relatesTo.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.relatesTo.modifierExtension">
          <path
                value="ArtifactAssessment.content.component.relatesTo.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.relatesTo.type">
          <path value="ArtifactAssessment.content.component.relatesTo.type"/>
          <short
                 value="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"/>
          <definition value="The type of relationship to the related artifact."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.relatesTo.type"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <patternCode value="depends-on"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ArtifactRelationshipType"/>
            </extension>
            <strength value="required"/>
            <description
                         value="The type of relationship to the related artifact."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/artifact-relationship-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.relatesTo.target[x]">
          <path value="ArtifactAssessment.content.component.relatesTo.target[x]"/>
          <slicing>
            <discriminator>
              <type value="type"/>
              <path value="$this"/>
            </discriminator>
            <ordered value="false"/>
            <rules value="closed"/>
          </slicing>
          <short value="The artifact that is related to this ArtifactAssessment"/>
          <definition
                      value="The artifact that is related to this ArtifactAssessment Resource."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.relatesTo.target[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Resource|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.relatesTo.target[x]:targetReference">
          <path value="ArtifactAssessment.content.component.relatesTo.target[x]"/>
          <sliceName value="targetReference"/>
          <short value="The artifact that is related to this ArtifactAssessment"/>
          <definition
                      value="The artifact that is related to this ArtifactAssessment Resource."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.relatesTo.target[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://fhir.awmf.org/awmf.ig/StructureDefinition/conceptual-cohort-definition-outcome"/>
            <targetProfile
                           value="http://fhir.awmf.org/awmf.ig/StructureDefinition/outcome-evidence"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.freeToShare">
          <path value="ArtifactAssessment.content.component.freeToShare"/>
          <short value="Acceptable to publicly share the content"/>
          <definition
                      value="Acceptable to publicly share the comment, classifier or rating."/>
          <comment
                   value="Absence of a value should be interpreted as inheriting any freeToShare value present in a containing structure, else inheriting data from the ArtifactAssessment.copyright element, else value unknown."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.freeToShare"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:outcome.component">
          <path value="ArtifactAssessment.content.component.component"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence">
          <path value="ArtifactAssessment.content.component"/>
          <sliceName value="overallQualityOfEvidence"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.id">
          <path value="ArtifactAssessment.content.component.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.extension">
          <path value="ArtifactAssessment.content.component.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.modifierExtension">
          <path value="ArtifactAssessment.content.component.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.summary">
          <path value="ArtifactAssessment.content.component.summary"/>
          <short value="Brief summary of the content"/>
          <definition value="A brief summary of the content of this component."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.summary"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.type">
          <path value="ArtifactAssessment.content.component.type"/>
          <short value="What type of content"/>
          <definition
                      value="Indicates what type of content this component represents."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <patternCodeableConcept>
            <coding>
              <system value="http://fhir.awmf.org/awmf.ig/CodeSystem/cs-awmf"/>
              <code value="overall-quality-of-evidence"/>
              <display value="Overall Quality of Evidence"/>
            </coding>
          </patternCodeableConcept>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyType"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.classifier">
          <path value="ArtifactAssessment.content.component.classifier"/>
          <short value="Rating, classifier, or assessment"/>
          <definition
                      value="Represents a rating, classifier, or assessment of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.classifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyRating"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-rating|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.quantity">
          <path value="ArtifactAssessment.content.component.quantity"/>
          <short value="Quantitative rating"/>
          <definition value="A quantitative rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.author">
          <path value="ArtifactAssessment.content.component.author"/>
          <short value="Who authored the content"/>
          <definition value="Indicates who or what authored the content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.author"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.path">
          <path value="ArtifactAssessment.content.component.path"/>
          <short value="What the comment is directed to"/>
          <definition
                      value="A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource."/>
          <comment
                   value="The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.path"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.relatesTo">
          <path value="ArtifactAssessment.content.component.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this content component has with other FHIR or non-FHIR resources that already exist."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.relatesTo.id">
          <path value="ArtifactAssessment.content.component.relatesTo.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.relatesTo.extension">
          <path value="ArtifactAssessment.content.component.relatesTo.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.relatesTo.modifierExtension">
          <path
                value="ArtifactAssessment.content.component.relatesTo.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.relatesTo.type">
          <path value="ArtifactAssessment.content.component.relatesTo.type"/>
          <short
                 value="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"/>
          <definition value="The type of relationship to the related artifact."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.relatesTo.type"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <patternCode value="justification"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ArtifactRelationshipType"/>
            </extension>
            <strength value="required"/>
            <description
                         value="The type of relationship to the related artifact."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/artifact-relationship-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.relatesTo.target[x]">
          <path value="ArtifactAssessment.content.component.relatesTo.target[x]"/>
          <slicing>
            <discriminator>
              <type value="type"/>
              <path value="$this"/>
            </discriminator>
            <ordered value="false"/>
            <rules value="closed"/>
          </slicing>
          <short value="The artifact that is related to this ArtifactAssessment"/>
          <definition
                      value="The artifact that is related to this ArtifactAssessment Resource."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.relatesTo.target[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Resource|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.relatesTo.target[x]:targetReference">
          <path value="ArtifactAssessment.content.component.relatesTo.target[x]"/>
          <sliceName value="targetReference"/>
          <short value="The artifact that is related to this ArtifactAssessment"/>
          <definition
                      value="The artifact that is related to this ArtifactAssessment Resource."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.relatesTo.target[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://fhir.awmf.org/awmf.ig/StructureDefinition/evidence-assessment"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.freeToShare">
          <path value="ArtifactAssessment.content.component.freeToShare"/>
          <short value="Acceptable to publicly share the content"/>
          <definition
                      value="Acceptable to publicly share the comment, classifier or rating."/>
          <comment
                   value="Absence of a value should be interpreted as inheriting any freeToShare value present in a containing structure, else inheriting data from the ArtifactAssessment.copyright element, else value unknown."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.freeToShare"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:overallQualityOfEvidence.component">
          <path value="ArtifactAssessment.content.component.component"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy">
          <path value="ArtifactAssessment.content"/>
          <sliceName value="searchStrategy"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human
                   value="All FHIR elements must have a @value or children or both"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy.id">
          <path value="ArtifactAssessment.content.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy.extension">
          <path value="ArtifactAssessment.content.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:searchStrategy.modifierExtension">
          <path value="ArtifactAssessment.content.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy.summary">
          <path value="ArtifactAssessment.content.summary"/>
          <short value="Brief summary of the content"/>
          <definition value="A brief summary of the content of this component."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.summary"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy.type">
          <path value="ArtifactAssessment.content.type"/>
          <short value="What type of content"/>
          <definition
                      value="Indicates what type of content this component represents."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.type"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <patternCodeableConcept>
            <coding>
              <system value="https://fevir.net/resources/CodeSystem/179423"/>
              <code value="SearchStrategy"/>
              <display value="SearchStrategy"/>
            </coding>
          </patternCodeableConcept>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyType"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy.classifier">
          <path value="ArtifactAssessment.content.classifier"/>
          <short value="Rating, classifier, or assessment"/>
          <definition
                      value="Represents a rating, classifier, or assessment of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.classifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EvidenceCertaintyRating"/>
            </extension>
            <strength value="example"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/certainty-rating|6.0.0-ballot3"/>
          </binding>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy.quantity">
          <path value="ArtifactAssessment.content.quantity"/>
          <short value="Quantitative rating"/>
          <definition value="A quantitative rating of the artifact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy.author">
          <path value="ArtifactAssessment.content.author"/>
          <short value="Who authored the content"/>
          <definition value="Indicates who or what authored the content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.author"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|6.0.0-ballot3"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy.path">
          <path value="ArtifactAssessment.content.path"/>
          <short value="What the comment is directed to"/>
          <definition
                      value="A URI that points to what the comment is about, such as a line of text in the CQL, or a specific element in a resource."/>
          <comment
                   value="The target element is used to point the comment to aspect of the artifact, such as a text range within a CQL library (e.g. #content?0:0-120:80)."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.path"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy.relatesTo">
          <path value="ArtifactAssessment.content.relatesTo"/>
          <short value="Relationship to other Resources"/>
          <definition
                      value="Relationship that this content component has with other FHIR or non-FHIR resources that already exist."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.relatesTo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy.relatesTo.id">
          <path value="ArtifactAssessment.content.relatesTo.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:searchStrategy.relatesTo.extension">
          <path value="ArtifactAssessment.content.relatesTo.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="ArtifactAssessment.content:searchStrategy.relatesTo.modifierExtension">
          <path value="ArtifactAssessment.content.relatesTo.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy.relatesTo.type">
          <path value="ArtifactAssessment.content.relatesTo.type"/>
          <short
                 value="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"/>
          <definition value="The type of relationship to the related artifact."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.relatesTo.type"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ArtifactRelationshipType"/>
            </extension>
            <strength value="required"/>
            <description
                         value="The type of relationship to the related artifact."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/artifact-relationship-type|6.0.0-ballot3"/>
          </binding>
        </element>
        <element
                 id="ArtifactAssessment.content:searchStrategy.relatesTo.target[x]">
          <path value="ArtifactAssessment.content.relatesTo.target[x]"/>
          <slicing>
            <discriminator>
              <type value="type"/>
              <path value="$this"/>
            </discriminator>
            <ordered value="false"/>
            <rules value="closed"/>
          </slicing>
          <short value="The artifact that is related to this ArtifactAssessment"/>
          <definition
                      value="The artifact that is related to this ArtifactAssessment Resource."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.relatesTo.target[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Resource|6.0.0-ballot3"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element
                 id="ArtifactAssessment.content:searchStrategy.relatesTo.target[x]:targetReference">
          <path value="ArtifactAssessment.content.relatesTo.target[x]"/>
          <sliceName value="targetReference"/>
          <short value="The artifact that is related to this ArtifactAssessment"/>
          <definition
                      value="The artifact that is related to this ArtifactAssessment Resource."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.relatesTo.target[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/uv/ebm/StructureDefinition/systematic-review"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy.freeToShare">
          <path value="ArtifactAssessment.content.freeToShare"/>
          <short value="Acceptable to publicly share the content"/>
          <definition
                      value="Acceptable to publicly share the comment, classifier or rating."/>
          <comment
                   value="Absence of a value should be interpreted as inheriting any freeToShare value present in a containing structure, else inheriting data from the ArtifactAssessment.copyright element, else value unknown."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.content.freeToShare"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.content:searchStrategy.component">
          <path value="ArtifactAssessment.content.component"/>
          <short value="Comment, classifier, or rating content"/>
          <definition
                      value="A component comment, classifier, or rating of the artifact."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="ArtifactAssessment.content.component"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/ArtifactAssessment#ArtifactAssessment.content"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="ArtifactAssessment.workflowStatus">
          <path value="ArtifactAssessment.workflowStatus"/>
          <short
                 value="submitted | triaged | waiting-for-input | resolved-no-change | resolved-change-required | deferred | duplicate | applied | published | entered-in-error"/>
          <definition
                      value="Indicates the workflow status of the comment or change request."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.workflowStatus"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <patternCode value="applied"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="WorkflowStatus"/>
            </extension>
            <strength value="required"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/artifactassessment-workflow-status|6.0.0-ballot3"/>
          </binding>
        </element>
        <element id="ArtifactAssessment.disposition">
          <path value="ArtifactAssessment.disposition"/>
          <short
                 value="unresolved | not-persuasive | persuasive | persuasive-with-modification | not-persuasive-with-modification"/>
          <definition
                      value="Indicates the disposition of the responsible party to the comment or change request."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="ArtifactAssessment.disposition"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="Disposition"/>
            </extension>
            <strength value="required"/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/artifactassessment-disposition|6.0.0-ballot3"/>
          </binding>
        </element>
      </snapshot>
      <differential>
        <element id="ArtifactAssessment">
          <path value="ArtifactAssessment"/>
        </element>
        <element id="ArtifactAssessment.content:evidenceRating">
          <path value="ArtifactAssessment.content"/>
          <sliceName value="evidenceRating"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem">
          <path value="ArtifactAssessment.content.component"/>
          <sliceName value="ratingSystem"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:ratingSystem.classifier">
          <path value="ArtifactAssessment.content.component.classifier"/>
          <patternCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/uv/ebm/CodeSystem/evidence-rating-system-classifier-codesystem"/>
              <code value="SIGN"/>
              <display value="SIGN"/>
            </coding>
          </patternCodeableConcept>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence">
          <path value="ArtifactAssessment.content.component"/>
          <sliceName value="levelOfEvidence"/>
        </element>
        <element
                 id="ArtifactAssessment.content:evidenceRating.component:levelOfEvidence.classifier">
          <path value="ArtifactAssessment.content.component.classifier"/>
          <binding>
            <strength value="preferred"/>
            <valueSet
                      value="http://fhir.awmf.org/awmf.ig/ValueSet/vs-sign-level-of-evidence"/>
          </binding>
        </element>
      </differential>
    </StructureDefinition>