import { CodeableConcept } from './CodeableConcept.js';
import { Coding } from './Coding.js';
import { ContactDetail } from './ContactDetail.js';
import { Extension } from './Extension.js';
import { FhirPrimitive } from './FhirPrimitive.js';
import { Identifier } from './Identifier.js';
import { Measure_Group } from './Measure_Group.js';
import { Measure_SupplementalData } from './Measure_SupplementalData.js';
import { Measure_Term } from './Measure_Term.js';
import { Meta } from './Meta.js';
import { Narrative } from './Narrative.js';
import { Period } from './Period.js';
import { Reference } from './Reference.js';
import { RelatedArtifact } from './RelatedArtifact.js';
import { Resource } from './Resource.js';
import { UsageContext } from './UsageContext.js';
export interface Measure {
    /**
     * @description The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
     * @comment 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.
     * @short Logical id of this artifact
     */
    id?: string;
    /**
     * @description 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.
     * @short Metadata about the resource
     */
    meta?: Meta;
    /**
     * @description 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 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 andor 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.
     * @short A set of rules under which this content was created
     */
    implicitRules?: FhirPrimitive<string>;
    /**
     * @description The base language in which the resource is written.
     * @comment 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).
     * @short Language of the resource content
     */
    language?: FhirPrimitive<string>;
    /**
     * @description 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 "clinically safe" 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 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 "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
     * @short Text summary of the resource, for human interpretation
     */
    text?: Narrative;
    /**
     * @description 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 contextmeaning.
     * @comment 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.
     * @short Contained, inline Resources
     */
    contained?: Resource[];
    /**
     * @description 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 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.
     * @short Additional content defined by implementations
     */
    extension?: Extension[];
    /**
     * @description 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 andor 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 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.
     * @short Extensions that cannot be ignored
     */
    modifierExtension?: Extension[];
    /**
     * @description An absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this measure is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the measure is stored on different servers.
     * @comment Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred.  Multiple instances may share the same URL if they have a distinct version.
  
  The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author.  Considerations for making this decision are found in [Technical and Business Versions](resource.html#versions).
  
  In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](resource.html#meta) element to indicate where the current master source of the resource can be found.
     * @short Canonical identifier for this measure, represented as a URI (globally unique)
     */
    url?: FhirPrimitive<string>;
    /**
     * @description A formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instance.
     * @comment Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI.
     * @short Additional identifier for the measure
     */
    identifier?: Identifier[];
    /**
     * @description The identifier that is used to identify this version of the measure when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the measure author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts.
     * @comment There may be different measure instances that have the same identifier but different versions.  The version can be appended to the url in a reference to allow a reference to a particular business version of the measure with the format [url]|[version]. The version SHOULD NOT contain a '#' - see [Business Version](resource.html#bv-format).
     * @short Business version of the measure
     */
    version?: FhirPrimitive<string>;
    /**
     * @choice This is part of the versionAlgorithm[x] choice.
     * @oneOf versionAlgorithmString, versionAlgorithmCoding
     */
    versionAlgorithmString?: FhirPrimitive<string>;
    /**
     * @choice This is part of the versionAlgorithm[x] choice.
     * @oneOf versionAlgorithmString, versionAlgorithmCoding
     */
    versionAlgorithmCoding?: Coding;
    /**
     * @description A natural language name identifying the measure. This name should be usable as an identifier for the module by machine processing applications such as code generation.
     * @comment The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.
     * @short Name for this measure (computer friendly)
     */
    name?: FhirPrimitive<string>;
    /**
     * @description A short, descriptive, user-friendly title for the measure.
     * @comment This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
     * @short Name for this measure (human friendly)
     */
    title?: FhirPrimitive<string>;
    /**
     * @description An explanatory or alternate title for the measure giving additional information about its content.
     * @short Subordinate title of the measure
     */
    subtitle?: FhirPrimitive<string>;
    /**
     * @description The status of this measure. Enables tracking the life-cycle of the content.
     * @comment Allows filtering of measures that are appropriate for use versus not.
  
  See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
     * @short draft | active | retired | unknown
     */
    status: FhirPrimitive<string>;
    /**
     * @description A Boolean value to indicate that this measure is authored for testing purposes (or educationevaluationmarketing) and is not intended to be used for genuine usage.
     * @comment Allows filtering of measures that are appropriate for use versus not.
     * @short For testing purposes, not real usage
     */
    experimental?: FhirPrimitive<boolean>;
    /**
     * @choice This is part of the subject[x] choice.
     * @oneOf subjectCodeableConcept, subjectReference
     */
    subjectCodeableConcept?: CodeableConcept;
    /**
     * @choice This is part of the subject[x] choice.
     * @oneOf subjectCodeableConcept, subjectReference
     */
    subjectReference?: Reference;
    /**
     * @description The population basis specifies the type of elements in the population. For a subject-based measure, this is boolean (because the subject and the population basis are the same, and the population criteria define yesno values for each individual in the population). For measures that have a population basis that is different than the subject, this element specifies the type of the population basis. For example, an encounter-based measure has a subject of Patient and a population basis of Encounter, and the population criteria all return lists of Encounters.
     * @comment For a subject-based measure, the population basis is simply boolean; all the criteria are expressed as truefalse conditions that determine membership of an individual case in the population. For non-subject-based measures, the population basis can be any resource type, and the criteria are queries that return the subject's contribution to the population as a list of that resource type. For example, for a procedure-based measure, the population criteria would return lists of procedures that should be included in each population.
     * @short Population basis
     */
    basis?: FhirPrimitive<string>;
    /**
     * @description The date  (and optionally time) when the measure was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the measure changes.
     * @comment 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 measure. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.
  
  See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
     * @short Date last changed
     */
    date?: FhirPrimitive<string>;
    /**
     * @description The name of the organization or individual responsible for the release and ongoing maintenance of the measure.
     * @comment Usually an organization but may be an individual. The publisher (or steward) of the measure is the organization or individual primarily responsible for the maintenance and upkeep of the measure. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the measure. This item SHOULD be populated unless the information is available from context.
     * @short Name of the publishersteward (organization or individual)
     */
    publisher?: FhirPrimitive<string>;
    /**
     * @description Contact details to assist a user in finding and communicating with the publisher.
     * @comment May be a web site, an email address, a telephone number, etc.
  
  See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
     * @short Contact details for the publisher
     */
    contact?: ContactDetail[];
    /**
     * @description A free text natural language description of the measure from a consumer's perspective.
     * @comment This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the measure as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the measure is presumed to be the predominant language in the place the measure was created).
     * @short Natural language description of the measure
     */
    description?: FhirPrimitive<string>;
    /**
     * @description The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate measure instances.
     * @comment When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
     * @short The context that the content is intended to support
     */
    useContext?: UsageContext[];
    /**
     * @description A legal or geographic region in which the measure is intended to be used.
     * @comment It may be possible for the measure to be used in jurisdictions other than those for which it was originally designed or intended.
  
  DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'jurisdiction' code in the useContext element.  (I.e. useContext.code indicating http:terminology.hl7.orgCodeSystemusage-context-type#jurisdiction and useContext.valueCodeableConcept indicating the jurisdiction.)
     * @short Intended jurisdiction for measure (if applicable)
     */
    jurisdiction?: CodeableConcept[];
    /**
     * @description Explanation of why this measure is needed and why it has been designed as it has.
     * @comment This element does not describe the usage of the measure. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is.  This may be used to point to source materials or specifications that drove the structure of this measure.
     * @short Why this measure is defined
     */
    purpose?: FhirPrimitive<string>;
    /**
     * @description A detailed description, from a clinical perspective, of how the measure is used.
     * @comment This metadata element was typically referred to as Guidance in HQMF
     * @short Describes the clinical usage of the measure
     */
    usage?: FhirPrimitive<string>;
    /**
     * @description A copyright statement relating to the measure andor its contents. Copyright statements are generally legal restrictions on the use and publishing of the measure.
     * @comment The short copyright declaration (e.g. (c) '2015+ xyz organization' should be sent in the copyrightLabel element.
     * @short Use andor publishing restrictions
     */
    copyright?: FhirPrimitive<string>;
    /**
     * @description A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').
     * @comment The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.
     * @short Copyright holder and year(s)
     */
    copyrightLabel?: FhirPrimitive<string>;
    /**
     * @description The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.
     * @comment The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.
  
  See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
     * @short When the measure was approved by publisher
     */
    approvalDate?: FhirPrimitive<string>;
    /**
     * @description The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.
     * @comment If specified, this date follows the original approval date.
  
  See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
     * @short When the measure was last reviewed by the publisher
     */
    lastReviewDate?: FhirPrimitive<string>;
    /**
     * @description The period during which the measure content was or is planned to be in active use.
     * @comment The effective period for a measure determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.
  
  See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
     * @short When the measure is expected to be used
     */
    effectivePeriod?: Period;
    /**
     * @description Descriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of measures that can be useful for filtering and searching.
     * @comment DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'topic' code in the useContext element.  (I.e. useContext.code indicating http:terminology.hl7.orgCodeSystemusage-context-type#topic and useContext.valueCodeableConcept indicating the topic)
     * @short The category of the measure, such as Education, Treatment, Assessment, etc
     */
    topic?: CodeableConcept[];
    /**
     * @description An individiual or organization primarily involved in the creation and maintenance of the content.
     * @short Who authored the content
     */
    author?: ContactDetail[];
    /**
     * @description An individual or organization primarily responsible for internal coherence of the content.
     * @short Who edited the content
     */
    editor?: ContactDetail[];
    /**
     * @description An individual or organization asserted by the publisher to be primarily responsible for review of some aspect of the content.
     * @comment See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
     * @short Who reviewed the content
     */
    reviewer?: ContactDetail[];
    /**
     * @description An individual or organization asserted by the publisher to be responsible for officially endorsing the content for use in some setting.
     * @comment See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
     * @short Who endorsed the content
     */
    endorser?: ContactDetail[];
    /**
     * @description Related artifacts such as additional documentation, justification, or bibliographic references.
     * @comment Each related artifact is either an attachment, or a reference to another resource, but not both.
     * @short Additional documentation, citations, etc
     */
    relatedArtifact?: RelatedArtifact[];
    /**
     * @description A reference to a Library resource containing the formal logic used by the measure.
     * @short Logic used by the measure
     */
    library?: FhirPrimitive<string>[];
    /**
     * @description Notices and disclaimers regarding the use of the measure or related to intellectual property (such as code systems) referenced by the measure.
     * @short Disclaimer for use of the measure or its referenced content
     */
    disclaimer?: FhirPrimitive<string>;
    /**
     * @description Indicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented.
     * @short proportion | ratio | continuous-variable | cohort
     */
    scoring?: CodeableConcept;
    /**
     * @description Defines the expected units of measure for the measure score. This element SHOULD be specified as a UCUM unit.
     * @comment When this element is specified, implementations are expected to report measure scores in the specified units. Note that this may involve unit conversion if the expected units are different than the units of the resulting score calculation. In this case, unit conversions SHALL be performed according to the unit conversion semantics specified by UCUM.
     * @short What units?
     */
    scoringUnit?: CodeableConcept;
    /**
     * @description If this is a composite measure, the scoring method used to combine the component measures to determine the composite score.
     * @short opportunity | all-or-nothing | linear | weighted
     */
    compositeScoring?: CodeableConcept;
    /**
     * @description Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.
     * @short process | outcome | structure | patient-reported-outcome | composite
     */
    type?: CodeableConcept[];
    /**
     * @description A description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure results.
     * @comment Describes the method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether a measure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow for more useful comparisons.
     * @short How risk adjustment is applied for this measure
     */
    riskAdjustment?: FhirPrimitive<string>;
    /**
     * @description Describes how to combine the information calculated, based on logic in each of several populations, into one summarized result.
     * @comment The measure rate for an organization or clinician is based upon the entities’ aggregate data and summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The aggregated data are derived from the results of a specific measure algorithm and, if appropriate, the application of specific risk adjustment models.  Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level).
     * @short How is rate aggregation performed for this measure
     */
    rateAggregation?: FhirPrimitive<string>;
    /**
     * @description Provides a succinct statement of the need for the measure. Usually includes statements pertaining to importance criterion: impact, gap in care, and evidence.
     * @short Detailed description of why the measure exists
     */
    rationale?: FhirPrimitive<string>;
    /**
     * @description Provides a summary of relevant clinical guidelines or other clinical recommendations supporting the measure.
     * @short Summary of clinical guidelines
     */
    clinicalRecommendationStatement?: FhirPrimitive<string>;
    /**
     * @description Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range).
     * @short increase | decrease
     */
    improvementNotation?: CodeableConcept;
    /**
     * @backbone Nested BackboneElement: term [0..*]
     */
    term?: Measure_Term[];
    /**
     * @description Additional guidance for the measure including how it can be used in a clinical context, and the intent of the measure.
     * @comment NOTE: This element is deprecated in favor of the usage element
     * @short Additional guidance for implementers (deprecated)
     */
    guidance?: FhirPrimitive<string>;
    /**
     * @backbone Nested BackboneElement: group [0..*]
     */
    group?: Measure_Group[];
    /**
     * @backbone Nested BackboneElement: supplementalData [0..*]
     */
    supplementalData?: Measure_SupplementalData[];
    /**
     * @const Auto-injected fixed value: Measure
     */
    resourceType: "Measure";
}
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