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CohortSummary FHIR Resource Proposal

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Owning work group name

Clinical Decision Support

Committee Approval Date:

Initial PSS for EBMonFHIR project: June 22, 2018 Resource Approval by CDS WG: May 7, 2019

Contributing or Reviewing Work Groups

Clincial Quality Information Biomedical Research and Regulation

FHIR Resource Development Project Insight ID


Scope of coverage

The scope of the CohortSummary resource is to describe the statistics about a group of entities, including associations of measured variables within the cohort.

Common types of statistics that will be reported includes means, medians, and proportions. Association statistics (such as correlation coefficient) will also be supported to report evidence about associations between observations.

Expressing summary characteristics for cohorts and evidence reports regarding associations is done throughout reporting of biomedical research, systematic reviews, and clinical reference across all disciplines.

RIM scope

Resource appropriateness

Across the evidence-based medicine community (hundreds of thousands of people communicating the results of healthcare research through original research and systematic reviews and expressing the findings from a body of evidence), the summary of cohort characteristics and associations of variables is the primary method of expressing quantitative results. Standardization is necessary to support interoperability across the evidence-based medicine domain.

Expected implementations

Many knowledge producers who express the biomedical research community knowledge will be the implementers using this resource. Examples of these knowledge producers include Agency for Healthcare Research and Quality (AHRQ), Centers for Disease Control and Prevention (CDC), Cochrane, Duodecim Medical Publications Ltd (from the Finnish Medical Society), EBSCO Health, MAGIC (stands for Making GRADE the Irresistible Choice), and numerous guideline development organizations. In addition Johns Hopkins University and other Clinical and Translational Science Awards (CTSA) Program participants of the NIH National Center for Advancing Translational Sciences (NCATS) have been anticipating a "ClinicalProfile" FHIR Resource that will be functionally replaced with the CohortSummary resource.

Content sources

None expected beyond the standard source specifications. However, the method for expressing citations (eg referring to a publication) is not yet defined and may require additional source specifications.

Example Scenarios

The CohortSummary resource describes:

descriptions of the population, exposure, and measured variables that statistics are about the statistics for summary reporting of measured variables in the cohort where statistic datatype can include classification of the statistic type, sample size for the statistic, quantity of the statistic, a precision estimate (such as a 95% confidence interval), and ratings of the certainty of the statistic descriptions of the source of the effect estimates (eg author, citation, type of research)

Resource Relationships

The CohortSummary Resource will reference Group Resource (to describe intended and actual population cohorts) and EvidenceVariable Resource (to describe exposures and measured variables)

Resource Boundaries

To be determined if implementers have questions that need explanations to support distinction and clarification. CohortSummary will describe association statistics where multiple measured variables are analyzed with one exposure. A similarly structured resource (ComparativeEvidence) will describe comparative statistics where one measured variable is analyzed with multiple exposures. The ComparativeEvidence and CohortSummary resources are purposefully created as separate resources to simplify the compound nesting relationships of exposures and measured variables for classifying statistics.


First STU Ballot 2019 September

gForge Users

brynrhodes (github user) KhalidShahin-EBSCO (github user)

When Resource Proposal Is Complete

When you have completed your proposal, please send an email to

FMG Notes