Clinical Practice Guidelines (CPG) on EBMonFHIR
1.2.0 - qa-preview

This page is part of the CPG-on-EBMonFHIR Implementation Guide (1.2.0).

Resource Profile: Clinical Practice Guideline

Defining URL:https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/StructureDefinition/guideline
Version:0.2.0
Name:Guideline
Title:Clinical Practice Guideline
Status:Draft as of 2022-12-08
Definition:

Representation of an evidence-based clinical practice guideline.

Publisher:Netzwerk Universitätsmedizin (NUM),
Source Resource:XML / JSON / Turtle

The official URL for this profile is: 

https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/StructureDefinition/guideline

Guidance

This profile represents a single clinical practice guideline. It serves as a container for the guideline metadata and the individual Recommendation resources that represent the recommendations of the guideline.

It thus provides a structured presentation of the whole guideline contents including the guideline metadata.

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

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. Composition 0..* Composition A set of resources composed into a single coherent clinical statement with clinical attestation
... id Σ 0..1 id Logical id of this artifact
... meta SΣ 1..1 Meta Metadata about the resource
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source SΣ 0..1 uri Identifies where the resource comes from
.... profile SΣ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: AllSecurityLabels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... url Σ 0..1 uri Canonical identifier for this Composition, represented as a URI (globally unique)
... identifier SΣ 1..1 Identifier Version-independent identifier for the Composition
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type SΣ 1..1 CodeableConcept Description of identifier
Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: RI
...... display 1..1 string Representation defined by the system
Fixed Value: Resource identifier
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
.... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣC 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... version SΣ 1..1 string An explicitly assigned identifer of a variation of the content in the Composition
... status ?!SΣ 1..1 code registered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown
Binding: CompositionStatus (required): The workflow/clinical status of the composition.

... type SΣ 1..1 CodeableConcept Kind of composition (LOINC if possible)
Binding: FHIRDocumentTypeCodes (preferred): Type of a composition.

.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by pattern:$this
..... coding:ceosys Σ 1..1 Coding Code defined by a terminology system

Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: clinical-practice-guideline
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣC 1..1 code Symbol in syntax defined by the system
...... display ΣC 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:cochrane Σ 1..1 Coding Code defined by a terminology system

Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://data.cochrane.org/concepts/
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: e07eN1w1Rwswg4
...... display 1..1 string Representation defined by the system
Fixed Value: Guidelines
...... userSelected 0..1 boolean If this coding was chosen directly by the user
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣC 1..1 code Symbol in syntax defined by the system
...... display ΣC 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... Slices for category Σ 0..* CodeableConcept Categorization of Composition
Slice: Unordered, Open by pattern:coding
Binding: ReferencedItemCategoryValueSet (example): High-level kind of a clinical document at a macro level.


.... category:stageClassification Σ 0..1 CodeableConcept Categorization of Composition
Binding: ReferencedItemCategoryValueSet (example): High-level kind of a clinical document at a macro level.


..... id 0..1 id Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ 0..* Coding Code defined by a terminology system
Binding: Guideline Stage Classification (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣC 1..1 code Symbol in syntax defined by the system
...... display ΣC 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
... date SΣ 1..1 dateTime Composition editing time
... useContext Σ 0..* UsageContext The context that the content is intended to support
... author Σ 1..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) Who and/or what authored the composition
... name Σ 0..1 string Name for this Composition (computer friendly)
... title SΣ 1..1 string Human Readable name/title
... note 0..* Annotation For any additional notes
... attester 0..* BackboneElement Attests to accuracy of composition
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... mode 1..1 CodeableConcept personal | professional | legal | official
Binding: CompositionAttestationMode (preferred): The way in which a person authenticated a composition.

.... time 0..1 dateTime When the composition was attested
.... party 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) Who attested the composition
... custodian Σ 0..1 Reference(Organization) Organization which maintains the composition
... relatesTo 0..1 RelatedArtifact Relationships to other compositions/documents
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... type Σ 1..1 code documentation | justification | citation | 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 | documents | specification-of | created-with | cite-as
Binding: RelatedArtifactType (required): The type of relationship to the related artifact.


Required Pattern: citation
.... classifier Σ 0..* CodeableConcept Additional classifiers
Binding: CitationArtifactClassifier (example): Additional classifiers for the related artifact.


.... label Σ 0..1 string Short label
.... display Σ 0..1 string Brief description of the related artifact
.... citation Σ 0..1 markdown Bibliographic citation for the artifact
.... document Σ 0..1 Attachment What document is being referenced
.... resource Σ 0..1 canonical(Resource) What artifact is being referenced
.... resourceReference Σ 1..1 Reference(Guideline Citation) What artifact, if not a conformance resource
.... publicationStatus Σ 0..1 code draft | active | retired | unknown
Binding: PublicationStatus (required): Publication status of an artifact being referred to.

.... publicationDate Σ 0..1 date Date of publication of the artifact being referred to
... event Σ 0..* BackboneElement The clinical service(s) being documented
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... period Σ 0..1 Period The period covered by the documentation
.... detail Σ 0..* CodeableReference(Resource) The event(s) being documented, as code(s), reference(s), or both
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.


... section SC 1..* BackboneElement Composition is broken into sections
cmp-1: A section must contain at least one of text, entries, or sub-sections
cmp-2: A section can only have an emptyReason if it is empty
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... title S 1..1 string Label for section (e.g. for ToC)
.... code S 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: guideline-recommendation
...... display 1..1 string Representation defined by the system
Fixed Value: Clinical practice guideline recommendation
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
.... author 0..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) Who and/or what authored the section
.... focus 0..1 Reference(Recommendation) Who/what the section is about, when it is not about the subject of composition
.... text C 0..1 Narrative Text summary of the section, for human interpretation
.... orderedBy 0..1 CodeableConcept Order of section entries
Binding: ListOrderCodes (preferred): What order applies to the items in the entry.

.... entry C 0..* Reference(Resource) A reference to data that supports this section
.... emptyReason C 0..1 CodeableConcept Why the section is empty
Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.

.... section 0..* See section (Composition) Nested Section

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Composition 0..* Composition A set of resources composed into a single coherent clinical statement with clinical attestation
... meta Σ 1..1 Meta Metadata about the resource
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
... identifier Σ 1..1 Identifier Version-independent identifier for the Composition
.... type Σ 1..1 CodeableConcept Description of identifier
Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: RI
...... display 1..1 string Representation defined by the system
Fixed Value: Resource identifier
.... system Σ 1..1 uri The namespace for the identifier value
.... value ΣC 1..1 string The value that is unique
... version Σ 1..1 string An explicitly assigned identifer of a variation of the content in the Composition
... type Σ 1..1 CodeableConcept Kind of composition (LOINC if possible)
Binding: FHIRDocumentTypeCodes (preferred): Type of a composition.

.... Slices for coding Content/Rules for all slices
..... coding:ceosys Σ 1..1 Coding Code defined by a terminology system

Required Pattern: At least the following
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: clinical-practice-guideline
...... system Σ 1..1 uri Identity of the terminology system
...... code ΣC 1..1 code Symbol in syntax defined by the system
..... coding:cochrane Σ 1..1 Coding Code defined by a terminology system

Required Pattern: At least the following
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://data.cochrane.org/concepts/
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: e07eN1w1Rwswg4
...... display 1..1 string Representation defined by the system
Fixed Value: Guidelines
...... system Σ 1..1 uri Identity of the terminology system
...... code ΣC 1..1 code Symbol in syntax defined by the system
... Slices for category Content/Rules for all slices
.... category:stageClassification Σ 0..1 CodeableConcept Categorization of Composition
..... coding Σ 0..* Coding Code defined by a terminology system
...... system Σ 1..1 uri Identity of the terminology system
...... code ΣC 1..1 code Symbol in syntax defined by the system
... date Σ 1..1 dateTime Composition editing time
... title Σ 1..1 string Human Readable name/title
... section C 1..* BackboneElement Composition is broken into sections
cmp-1: A section must contain at least one of text, entries, or sub-sections
cmp-2: A section can only have an emptyReason if it is empty
.... title 1..1 string Label for section (e.g. for ToC)
.... code 1..1 CodeableConcept Classification of section (recommended)
Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.


Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: guideline-recommendation
...... display 1..1 string Representation defined by the system
Fixed Value: Clinical practice guideline recommendation

doco Documentation for this format

This structure is derived from Composition

NameFlagsCard.TypeDescription & Constraintsdoco
.. Composition Composition
... meta S 1..1 Meta Metadata about the resource
.... source S 0..1 uri Identifies where the resource comes from
.... profile S 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
... identifier S 1..1 Identifier Version-independent identifier for the Composition
.... type S 1..1 CodeableConcept Description of identifier
Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: RI
...... display 1..1 string Representation defined by the system
Fixed Value: Resource identifier
.... system S 1..1 uri The namespace for the identifier value
.... value S 1..1 string The value that is unique
... version S 1..1 string An explicitly assigned identifer of a variation of the content in the Composition
... type S 1..1 CodeableConcept Kind of composition (LOINC if possible)
.... Slices for coding 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by pattern:$this
..... coding:ceosys 1..1 Coding Code defined by a terminology system
Required Pattern: At least the following
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: clinical-practice-guideline
...... system S 1..1 uri Identity of the terminology system
...... code S 1..1 code Symbol in syntax defined by the system
..... coding:cochrane 1..1 Coding Code defined by a terminology system
Required Pattern: At least the following
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://data.cochrane.org/concepts/
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: e07eN1w1Rwswg4
...... display 1..1 string Representation defined by the system
Fixed Value: Guidelines
...... system S 1..1 uri Identity of the terminology system
...... code S 1..1 code Symbol in syntax defined by the system
... Slices for category 0..* CodeableConcept Categorization of Composition
Slice: Unordered, Open by pattern:coding
.... category:stageClassification 0..1 CodeableConcept Categorization of Composition
..... coding 0..* Coding Code defined by a terminology system
Binding: Guideline Stage Classification (required)
...... system S 1..1 uri Identity of the terminology system
...... code S 1..1 code Symbol in syntax defined by the system
... subject 0..0
... encounter 0..0
... date S 1..1 dateTime Composition editing time
... title S 1..1 string Human Readable name/title
... relatesTo 0..1 RelatedArtifact Relationships to other compositions/documents
.... type 1..1 code documentation | justification | citation | 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 | documents | specification-of | created-with | cite-as
Required Pattern: citation
.... resourceReference 1..1 Reference(Guideline Citation) What artifact, if not a conformance resource
... section S 1..* BackboneElement Composition is broken into sections
.... title S 1..1 string Label for section (e.g. for ToC)
.... code S 1..1 CodeableConcept Classification of section (recommended)
Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/CodeSystem/ceosys-code-system
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: guideline-recommendation
...... display 1..1 string Representation defined by the system
Fixed Value: Clinical practice guideline recommendation
.... focus 0..1 Reference(Recommendation) Who/what the section is about, when it is not about the subject of composition

doco Documentation for this format

This structure is derived from Composition

Summary

Mandatory: 16 elements(3 nested mandatory elements)
Must-Support: 21 elements
Prohibited: 2 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Composition.type.coding
  • The element 1 is sliced based on the value of Composition.category

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet / CodeURI
Composition.meta.securityextensibleAllSecurityLabels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Composition.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Composition.languagerequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages|5.0.0
from the FHIR Standard
Composition.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|5.0.0
from the FHIR Standard
Composition.identifier.typeextensiblePattern: RI("Resource identifier")
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Composition.statusrequiredCompositionStatus
http://hl7.org/fhir/ValueSet/composition-status|5.0.0
from the FHIR Standard
Composition.typepreferredFHIRDocumentTypeCodes
http://hl7.org/fhir/ValueSet/doc-typecodes
from the FHIR Standard
Composition.categoryexampleReferencedItemCategoryValueSet
http://hl7.org/fhir/ValueSet/referenced-item-category
from the FHIR Standard
Composition.category:stageClassificationexampleReferencedItemCategoryValueSet
http://hl7.org/fhir/ValueSet/referenced-item-category
from the FHIR Standard
Composition.category:stageClassification.codingrequiredGuidelineStageClassificationVS (a valid code from Guideline Stage Classification)
https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/ValueSet/vs-guideline-stage-classification
from this IG
Composition.attester.modepreferredCompositionAttestationMode
http://hl7.org/fhir/ValueSet/composition-attestation-mode
from the FHIR Standard
Composition.relatesTo.typerequiredPattern: citation
http://hl7.org/fhir/ValueSet/related-artifact-type|5.0.0
from the FHIR Standard
Composition.relatesTo.classifierexampleCitationArtifactClassifier
http://hl7.org/fhir/ValueSet/citation-artifact-classifier
from the FHIR Standard
Composition.relatesTo.publicationStatusrequiredPublicationStatus
http://hl7.org/fhir/ValueSet/publication-status|5.0.0
from the FHIR Standard
Composition.event.detailexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
Composition.section.codeexamplePattern: guideline-recommendation("Clinical practice guideline recommendation")
http://hl7.org/fhir/ValueSet/doc-section-codes
from the FHIR Standard
Composition.section.orderedBypreferredListOrderCodes
http://hl7.org/fhir/ValueSet/list-order
from the FHIR Standard
Composition.section.emptyReasonpreferredListEmptyReasons
http://hl7.org/fhir/ValueSet/list-empty-reason
from the FHIR Standard