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Specification:

FHIR Core (FHIR)
Raised in Version:

R5
Work Group:

Clinical Decision Support
Related URL:
http://build.fhir.org/evidencevariable.html
Related Artifact(s):

EvidenceVariable
Grouping:
- EBM
Resolution Description:

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Propose removing "intersection" and "union" codes, then changing characteristicCombination to be a Backbone element with the following elements:

code code 1..1 bound required to CharacteristicCombination value set
threshold positiveInt 0..1, provides the value of "n" when "at-least" or "at-most" codes are used

Then the codes are:

all-of
any-of
at-least
at-most
net-effect

And define an invariant that requires the presence of threshold if "at-least" or "at-most" are used and not present if any other code is used.

Show
Propose removing "intersection" and "union" codes, then changing characteristicCombination to be a Backbone element with the following elements: code code 1..1 bound required to CharacteristicCombination value set threshold positiveInt 0..1, provides the value of "n" when "at-least" or "at-most" codes are used Then the codes are: all-of any-of at-least at-most net-effect And define an invariant that requires the presence of threshold if "at-least" or "at-most" are used and not present if any other code is used.
Resolution Vote:
Brian Alper/Chris Moesel: 14-0-1
Change Category:
Enhancement
Change Impact:
Non-compatible
Applied for Version:

R5

EvidenceVariable.characteristicCombination is currently limited to datatype code with only 2 choices (intersection or union).

A change to CodeableConcept with Extensible binding strength will allow more combinatorial options, such as:

--meeting 3 of 5 characteristics

--net effect which is a statistical combination of characteristics

An initial CharacteristicCombination value set (to replace http://build.fhir.org/valueset-characteristic-combination.html) can include:

all-of	All of	Combine characteristics with AND.
any-of	Any of	Combine characteristics with OR.
at-least-2	At least 2	Meet at least 2 characteristics for definition.
at-least-3	At least 3	Meet at least 3 characteristics for definition.
at-least-4	At least 4	Meet at least 4 characteristics for definition.
net-effect	Net effect	Combine characteristics statistically.