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

## Extension: Recommendation Review Status

Official URL: http://fhir.awmf.org/awmf.ig/StructureDefinition/ext-recommendation-review-status | Version: 0.2.0
Draft as of 2026-01-29 | Computable Name: RecommendationReviewStatus

This extension allows for the indication of the status of a recommendation in the context of an updated guideline version along with an optional explanatory text

The RecommendationReviewStatus extension is used to indicate whether a recommendation has been added, updated, reviewed, or reaffirmed in the new guideline version, as well as to add an explanation text related to the status.

Context of Use

This extension may be used on the following element(s)

- Element ID: `Composition`

### Guidance

This extension indicates the status of a recommendation in the context of an updated guideline version, along with an optional explanatory text.

#### Overview

When guidelines are updated, recommendations may be added, modified, reviewed without changes, or reaffirmed. This extension tracks how each recommendation evolved between versions.

#### Context

This extension can be applied to any `Element` (typically recommendations).

#### Structure

The extension contains two sub-extensions:

Extension | Cardinality | Type | Description
--- | --- | --- | ---
`review-status` | 1..1 | CodeableConcept | Status code from the review status value set
`review-status-text` | 0..1 | string | Optional explanation of the status

#### Available Status Codes

Typical values include:

- `new` – New recommendation in this version
- `updated` – Recommendation has been modified
- `reviewed` – Recommendation was reviewed but not changed
- `reaffirmed` – Recommendation explicitly confirmed without changes

#### Example Usage

    * extension[reviewStatus]
      * extension[review-status].valueCodeableConcept from vs-recommendation-review-status (required)
      * extension[review-status].valueCodeableConcept = #updated
      * extension[review-status-text].valueString = "Updated based on new RCT evidence published in 2024"

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

Usage info

Usages:

- Use this Extension: Recommendation
- Examples for this Extension: Composition/RecommendationCognitiveTestsWhenSuspectingDementia

You can also check for usages in the FHIR IG Statistics

### Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

- Differential Table
- Snapshot Table
- Statistics/References
- All

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..1 | Extension | Version status of recommendation, i.e., confirmed, updated or new
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:review-status |  | 1..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "review-status"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Recommendation Review Status Value Set (required)
extension:review-status-text |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "review-status-text"
value[x] |  | 0..1 | string | Value of extension
url |  | 1..1 | uri | "http://fhir.awmf.org/awmf.ig/StructureDefinition/ext-recommendation-review-status"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..1 | Extension | Version status of recommendation, i.e., confirmed, updated or new
id |  | 0..1 | id | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:review-status |  | 1..1 | Extension | Extension
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url | Σ | 1..1 | uri | "review-status"
value[x] | Σ | 0..1 | CodeableConcept | Value of extension Binding: Recommendation Review Status Value Set (required)
extension:review-status-text |  | 0..1 | Extension | Extension
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url | Σ | 1..1 | uri | "review-status-text"
value[x] | Σ | 0..1 | string | Value of extension
url | Σ | 1..1 | uri | "http://fhir.awmf.org/awmf.ig/StructureDefinition/ext-recommendation-review-status"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: This extension allows for the indication of the status of a recommendation in the context of an updated guideline version along with an optional explanatory text

- review-status: CodeableConcept: An Extension
- review-status-text: string: An Extension

Differential View

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..1 | Extension | Version status of recommendation, i.e., confirmed, updated or new
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:review-status |  | 1..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "review-status"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Recommendation Review Status Value Set (required)
extension:review-status-text |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "review-status-text"
value[x] |  | 0..1 | string | Value of extension
url |  | 1..1 | uri | "http://fhir.awmf.org/awmf.ig/StructureDefinition/ext-recommendation-review-status"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..1 | Extension | Version status of recommendation, i.e., confirmed, updated or new
id |  | 0..1 | id | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:review-status |  | 1..1 | Extension | Extension
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url | Σ | 1..1 | uri | "review-status"
value[x] | Σ | 0..1 | CodeableConcept | Value of extension Binding: Recommendation Review Status Value Set (required)
extension:review-status-text |  | 0..1 | Extension | Extension
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url | Σ | 1..1 | uri | "review-status-text"
value[x] | Σ | 0..1 | string | Value of extension
url | Σ | 1..1 | uri | "http://fhir.awmf.org/awmf.ig/StructureDefinition/ext-recommendation-review-status"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: This extension allows for the indication of the status of a recommendation in the context of an updated guideline version along with an optional explanatory text

- review-status: CodeableConcept: An Extension
- review-status-text: string: An Extension

Other representations of profile: CSV, Excel, Schematron

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:review-status.​value[x] | Base | required | Recommendation Review Status Value Set | 📦0.2.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`