EffectEvidenceSynthesis

The EffectEvidenceSynthesis resource describes the difference in an outcome between exposures states in a population where the effect estimate is derived from a combination of research studies.

Schema

Elements

Name	Required	Type	Description
url		uri	Canonical identifier for this effect evidence synthesis, represented as a URI (globally unique) Details An absolute URI that is used to identify this effect evidence synthesis 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 at which an authoritative instance of this effect evidence synthesis is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the effect evidence synthesis is stored on different servers. 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.
identifier		Identifier[]	Additional identifier for the effect evidence synthesis Details A formal identifier that is used to identify this effect evidence synthesis when it is represented in other formats, or referenced in a specification, model, design or an instance. Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this effect evidence synthesis outside of FHIR, where it is not possible to use the logical URI.
version		string	Business version of the effect evidence synthesis Details The identifier that is used to identify this version of the effect evidence synthesis when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the effect evidence synthesis 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. There may be different effect evidence synthesis 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 effect evidence synthesis with the format [url]|[version].
name		string	Name for this effect evidence synthesis (computer friendly) Details A natural language name identifying the effect evidence synthesis. This name should be usable as an identifier for the module by machine processing applications such as code generation. 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.
title		string	Name for this effect evidence synthesis (human friendly) Details A short, descriptive, user-friendly title for the effect evidence synthesis. This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
status	✓	code	draft | active | retired | unknown Details The status of this effect evidence synthesis. Enables tracking the life-cycle of the content. Allows filtering of effect evidence synthesiss that are appropriate for use versus not.
date		dateTime	Date last changed Details The date (and optionally time) when the effect evidence synthesis was published. 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 effect evidence synthesis changes. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the effect evidence synthesis. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.
publisher		string	Name of the publisher (organization or individual) Details The name of the organization or individual that published the effect evidence synthesis. Usually an organization but may be an individual. The publisher (or steward) of the effect evidence synthesis is the organization or individual primarily responsible for the maintenance and upkeep of the effect evidence synthesis. 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 effect evidence synthesis. This item SHOULD be populated unless the information is available from context.
contact		ContactDetail[]	Contact details for the publisher Details Contact details to assist a user in finding and communicating with the publisher. May be a web site, an email address, a telephone number, etc.
description		markdown	Natural language description of the effect evidence synthesis Details A free text natural language description of the effect evidence synthesis from a consumer's perspective. This description can be used to capture details such as why the effect evidence synthesis was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the effect evidence synthesis 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 effect evidence synthesis is presumed to be the predominant language in the place the effect evidence synthesis was created).
note		Annotation[]	Used for footnotes or explanatory notes Details A human-readable string to clarify or explain concepts about the resource.
useContext		UsageContext[]	The context that the content is intended to support Details 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 effect evidence synthesis instances. When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
jurisdiction		CodeableConcept[]	Intended jurisdiction for effect evidence synthesis (if applicable) Details A legal or geographic region in which the effect evidence synthesis is intended to be used. It may be possible for the effect evidence synthesis to be used in jurisdictions other than those for which it was originally designed or intended.
copyright		markdown	Use and/or publishing restrictions Details A copyright statement relating to the effect evidence synthesis and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the effect evidence synthesis.
approvalDate		date	When the effect evidence synthesis was approved by publisher Details The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage. The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.
lastReviewDate		date	When the effect evidence synthesis was last reviewed Details The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date. If specified, this date follows the original approval date.
effectivePeriod		Period	When the effect evidence synthesis is expected to be used Details The period during which the effect evidence synthesis content was or is planned to be in active use. The effective period for a effect evidence synthesis 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.
topic		CodeableConcept[]	The category of the EffectEvidenceSynthesis, such as Education, Treatment, Assessment, etc. Details Descriptive topics related to the content of the EffectEvidenceSynthesis. Topics provide a high-level categorization grouping types of EffectEvidenceSynthesiss that can be useful for filtering and searching.
author		ContactDetail[]	Who authored the content Details An individiual or organization primarily involved in the creation and maintenance of the content.
editor		ContactDetail[]	Who edited the content Details An individual or organization primarily responsible for internal coherence of the content.
reviewer		ContactDetail[]	Who reviewed the content Details An individual or organization primarily responsible for review of some aspect of the content.
endorser		ContactDetail[]	Who endorsed the content Details An individual or organization responsible for officially endorsing the content for use in some setting.
relatedArtifact		RelatedArtifact[]	Additional documentation, citations, etc. Details Related artifacts such as additional documentation, justification, or bibliographic references. Each related artifact is either an attachment, or a reference to another resource, but not both.
synthesisType		CodeableConcept	Type of synthesis Details Type of synthesis eg meta-analysis.
studyType		CodeableConcept	Type of study Details Type of study eg randomized trial.
population	✓	Reference<EvidenceVariable>	What population? Details A reference to a EvidenceVariable resource that defines the population for the research.
exposure	✓	Reference<EvidenceVariable>	What exposure? Details A reference to a EvidenceVariable resource that defines the exposure for the research.
exposureAlternative	✓	Reference<EvidenceVariable>	What comparison exposure? Details A reference to a EvidenceVariable resource that defines the comparison exposure for the research.
outcome	✓	Reference<EvidenceVariable>	What outcome? Details A reference to a EvidenceVariable resomece that defines the outcome for the research.
sampleSize		EffectEvidenceSynthesisSampleSize	What sample size was involved? Details A description of the size of the sample involved in the synthesis.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, 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. 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). 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.
description		string	Description of sample size Details Human-readable summary of sample size.
numberOfStudies		integer	How many studies? Details Number of studies included in this evidence synthesis.
numberOfParticipants		integer	How many participants? Details Number of participants included in this evidence synthesis.
resultsByExposure		EffectEvidenceSynthesisResultsByExposure[]	What was the result per exposure? Details A description of the results for each exposure considered in the effect estimate.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, 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. 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). 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.
description		string	Description of results by exposure Details Human-readable summary of results by exposure state.
exposureState		code	exposure | exposure-alternative Details Whether these results are for the exposure state or alternative exposure state.
variantState		CodeableConcept	Variant exposure states Details Used to define variant exposure states such as low-risk state.
riskEvidenceSynthesis	✓	Reference<RiskEvidenceSynthesis>	Risk evidence synthesis Details Reference to a RiskEvidenceSynthesis resource.
effectEstimate		EffectEvidenceSynthesisEffectEstimate[]	What was the estimated effect Details The estimated effect of the exposure variant.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, 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. 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). 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.
description		string	Description of effect estimate Details Human-readable summary of effect estimate.
type		CodeableConcept	Type of efffect estimate Details Examples include relative risk and mean difference.
variantState		CodeableConcept	Variant exposure states Details Used to define variant exposure states such as low-risk state.
value		decimal	Point estimate Details The point estimate of the effect estimate.
unitOfMeasure		CodeableConcept	What unit is the outcome described in? Details Specifies the UCUM unit for the outcome.
precisionEstimate		EffectEvidenceSynthesisEffectEstimatePrecisionEstimate[]	How precise the estimate is Details A description of the precision of the estimate for the effect.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, 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. 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). 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.
type		CodeableConcept	Type of precision estimate Details Examples include confidence interval and interquartile range.
level		decimal	Level of confidence interval Details Use 95 for a 95% confidence interval.
from		decimal	Lower bound Details Lower bound of confidence interval.
to		decimal	Upper bound Details Upper bound of confidence interval.
certainty		EffectEvidenceSynthesisCertainty[]	How certain is the effect Details A description of the certainty of the effect estimate.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, 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. 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). 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.
rating		CodeableConcept[]	Certainty rating Details A rating of the certainty of the effect estimate.
note		Annotation[]	Used for footnotes or explanatory notes Details A human-readable string to clarify or explain concepts about the resource.
certaintySubcomponent		EffectEvidenceSynthesisCertaintyCertaintySubcomponent[]	A component that contributes to the overall certainty Details A description of a component of the overall certainty.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, 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. 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). 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.
type		CodeableConcept	Type of subcomponent of certainty rating Details Type of subcomponent of certainty rating.
rating		CodeableConcept[]	Subcomponent certainty rating Details A rating of a subcomponent of rating certainty.
note		Annotation[]	Used for footnotes or explanatory notes Details A human-readable string to clarify or explain concepts about the resource.

Search Parameters

Name	Type	Description	Expression
context	token	A use context assigned to the effect evidence synthesis	EffectEvidenceSynthesis.useContext.value as CodeableConcept
context-quantity	quantity	A quantity- or range-valued use context assigned to the effect evidence synthesis	EffectEvidenceSynthesis.useContext.value as Quantity | EffectEvidenceSynthesis.useContext.value as Range
context-type	token	A type of use context assigned to the effect evidence synthesis	EffectEvidenceSynthesis.useContext.code
date	date	The effect evidence synthesis publication date	EffectEvidenceSynthesis.date
description	string	The description of the effect evidence synthesis	EffectEvidenceSynthesis.description
effective	date	The time during which the effect evidence synthesis is intended to be in use	EffectEvidenceSynthesis.effectivePeriod
identifier	token	External identifier for the effect evidence synthesis	EffectEvidenceSynthesis.identifier
jurisdiction	token	Intended jurisdiction for the effect evidence synthesis	EffectEvidenceSynthesis.jurisdiction
name	string	Computationally friendly name of the effect evidence synthesis	EffectEvidenceSynthesis.name
publisher	string	Name of the publisher of the effect evidence synthesis	EffectEvidenceSynthesis.publisher
status	token	The current status of the effect evidence synthesis	EffectEvidenceSynthesis.status
title	string	The human-friendly name of the effect evidence synthesis	EffectEvidenceSynthesis.title
url	uri	The uri that identifies the effect evidence synthesis	EffectEvidenceSynthesis.url
version	token	The business version of the effect evidence synthesis	EffectEvidenceSynthesis.version
context-type-quantity	composite	A use context type and quantity- or range-based value assigned to the effect evidence synthesis	EffectEvidenceSynthesis.useContext
context-type-value	composite	A use context type and value assigned to the effect evidence synthesis	EffectEvidenceSynthesis.useContext

Inherited Elements

Name	Required	Type	Description
id		string	Logical id of this artifact Details The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
meta		Meta	Metadata about the resource Details 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.
implicitRules		uri	A set of rules under which this content was created Details 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. 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 and/or 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 it's narrative along with other profiles, value sets, etc.
language		code	Language of the resource content Details The base language in which the resource is written. 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).
text		Narrative	Text summary of the resource, for human interpretation Details 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. Contained resources do not have 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.
contained		Resource[]	Contained, inline Resources Details These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. 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.
extension		Extension[]	Additional content defined by implementations Details 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 manageable, 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored Details 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, 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). 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.

Usage

The scope of the EffectEvidenceSynthesis resource is to describe the estimates of an effect of an exposure on an outcome where the effect estimates are derived from the combination of research studies. Effect estimates are a measure of difference between the exposure state and an alternative exposure state (often called the control or comparator state) Expressing effect estimates is done throughout reporting of biomedical research, systematic reviews, and clinical reference across all disciplines.