EMA Write PMS API Implementation Guide - Enrichments
1.0.0 - ci-build

EMA Write PMS API Implementation Guide - Enrichments - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Data Type Profile: EmaRatioRange - Detailed Descriptions

Draft as of 2025-04-04

Definitions for the emaRatioRange data type profile.

Guidance on how to interpret the contents of this table can be found here

0. RatioRange
Definition

A range of ratios expressed as a low and high numerator and a denominator.

ShortRange of ratio values
Comments

The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.

Control0..*
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ratrng-1: One of lowNumerator or highNumerator and denominator SHALL be present, or all are absent. If all are absent, there SHALL be some extension present (((lowNumerator.exists() or highNumerator.exists()) and denominator.exists()) or (lowNumerator.empty() and highNumerator.empty() and denominator.empty() and extension.exists()))
ratrng-2: If present, lowNumerator SHALL have a lower value than highNumerator (lowNumerator.hasValue().not() or highNumerator.hasValue().not() or (lowNumerator.lowBoundary() <= highNumerator.highBoundary()))
2. RatioRange.lowNumerator
Definition

The value of the low limit numerator.

ShortLow Numerator limit
Comments

If the low element is missing, the low boundary is not known.

Control10..1
This element is affected by the following invariants: ratrng-1, ratrng-2
BindingThe codes SHALL be taken from For codes, see Unit of Measurement
(required to http://ema.europa.eu/fhir/vs/unitsOfMeasurementVs)
TypeQuantity(SimpleQuantity)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. RatioRange.lowNumerator.value
Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

ShortNumerical value (with implicit precision)
Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Control10..1
Typedecimal
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. RatioRange.lowNumerator.comparator
Definition

Not allowed to be used in this context


How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

Short< | <= | >= | > | ad - how to understand the value
Control0..01
BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0
(required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

How the Quantity should be understood and represented.

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Meaning if MissingIf there is no comparator, then there is no modification of the value
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. RatioRange.lowNumerator.unit
Definition

A human-readable form of the unit.

ShortUnit representation
Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. RatioRange.highNumerator
Definition

The value of the high limit numerator.

ShortHigh Numerator limit
Comments

If the high element is missing, the high boundary is not known.

Control10..1
This element is affected by the following invariants: ratrng-1, ratrng-2
BindingThe codes SHALL be taken from For codes, see Unit of Measurement
(required to http://ema.europa.eu/fhir/vs/unitsOfMeasurementVs)
TypeQuantity(SimpleQuantity)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. RatioRange.highNumerator.value
Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

ShortNumerical value (with implicit precision)
Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Control10..1
Typedecimal
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. RatioRange.highNumerator.comparator
Definition

Not allowed to be used in this context


How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

Short< | <= | >= | > | ad - how to understand the value
Control0..01
BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0
(required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

How the Quantity should be understood and represented.

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Meaning if MissingIf there is no comparator, then there is no modification of the value
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. RatioRange.highNumerator.unit
Definition

A human-readable form of the unit.

ShortUnit representation
Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. RatioRange.denominator
Definition

The value of the denominator.

ShortDenominator value
Control10..1
This element is affected by the following invariants: ratrng-1
BindingThe codes SHALL be taken from For codes, see Units of Presentation
(required to http://ema.europa.eu/fhir/vs/unitsOfPresentation)
TypeQuantity(SimpleQuantity)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. RatioRange.denominator.value
Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

ShortNumerical value (with implicit precision)
Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Control10..1
Typedecimal
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. RatioRange.denominator.comparator
Definition

Not allowed to be used in this context


How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

Short< | <= | >= | > | ad - how to understand the value
Control0..01
BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0
(required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

How the Quantity should be understood and represented.

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Meaning if MissingIf there is no comparator, then there is no modification of the value
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. RatioRange.denominator.unit
Definition

A human-readable form of the unit.

ShortUnit representation
Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. RatioRange
2. RatioRange.lowNumerator
Control1..?
BindingThe codes SHALL be taken from Unit of Measurement
(required to http://ema.europa.eu/fhir/vs/unitsOfMeasurementVs)
4. RatioRange.lowNumerator.value
Control1..?
6. RatioRange.lowNumerator.unit
Control1..?
8. RatioRange.highNumerator
Control1..?
BindingThe codes SHALL be taken from Unit of Measurement
(required to http://ema.europa.eu/fhir/vs/unitsOfMeasurementVs)
10. RatioRange.highNumerator.value
Control1..?
12. RatioRange.highNumerator.unit
Control1..?
14. RatioRange.denominator
Control1..?
BindingThe codes SHALL be taken from Units of Presentation
(required to http://ema.europa.eu/fhir/vs/unitsOfPresentation)
16. RatioRange.denominator.value
Control1..?
18. RatioRange.denominator.unit
Control1..?

Guidance on how to interpret the contents of this table can be found here

0. RatioRange
Definition

A range of ratios expressed as a low and high numerator and a denominator.

ShortRange of ratio values
Comments

The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.

Control0..*
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ratrng-1: One of lowNumerator or highNumerator and denominator SHALL be present, or all are absent. If all are absent, there SHALL be some extension present (((lowNumerator.exists() or highNumerator.exists()) and denominator.exists()) or (lowNumerator.empty() and highNumerator.empty() and denominator.empty() and extension.exists()))
ratrng-2: If present, lowNumerator SHALL have a lower value than highNumerator (lowNumerator.hasValue().not() or highNumerator.hasValue().not() or (lowNumerator.lowBoundary() <= highNumerator.highBoundary()))
2. RatioRange.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
This element is affected by the following invariants: ele-1
Typeid
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
4. RatioRange.extension
Definition

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 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.

ShortAdditional content defined by implementations
Comments

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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on RatioRange.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. RatioRange.lowNumerator
    Definition

    The value of the low limit numerator.

    ShortLow Numerator limit
    Comments

    If the low element is missing, the low boundary is not known.

    Control1..1
    This element is affected by the following invariants: ratrng-1, ratrng-2
    BindingThe codes SHALL be taken from Unit of Measurement
    (required to http://ema.europa.eu/fhir/vs/unitsOfMeasurementVs)
    TypeQuantity(SimpleQuantity)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    8. RatioRange.lowNumerator.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    This element is affected by the following invariants: ele-1
    Typeid
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    10. RatioRange.lowNumerator.extension
    Definition

    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 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.

    ShortAdditional content defined by implementations
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on RatioRange.lowNumerator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 12. RatioRange.lowNumerator.value
      Definition

      The value of the measured amount. The value includes an implicit precision in the presentation of the value.

      ShortNumerical value (with implicit precision)
      Comments

      The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

      Control1..1
      Typedecimal
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Precision is handled implicitly in almost all cases of measurement.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. RatioRange.lowNumerator.comparator
      Definition

      Not allowed to be used in this context

      Short< | <= | >= | > | ad - how to understand the value
      Control0..0
      BindingThe codes SHALL be taken from QuantityComparator
      (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

      How the Quantity should be understood and represented.

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

      Meaning if MissingIf there is no comparator, then there is no modification of the value
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. RatioRange.lowNumerator.unit
      Definition

      A human-readable form of the unit.

      ShortUnit representation
      Control1..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. RatioRange.lowNumerator.system
      Definition

      The identification of the system that provides the coded form of the unit.

      ShortSystem that defines coded unit form
      Control0..1
      This element is affected by the following invariants: qty-3
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need to know the system that defines the coded form of the unit.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. RatioRange.lowNumerator.code
      Definition

      A computer processable form of the unit in some unit representation system.

      ShortCoded form of the unit
      Comments

      The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

      Control0..1
      This element is affected by the following invariants: qty-3
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. RatioRange.highNumerator
      Definition

      The value of the high limit numerator.

      ShortHigh Numerator limit
      Comments

      If the high element is missing, the high boundary is not known.

      Control1..1
      This element is affected by the following invariants: ratrng-1, ratrng-2
      BindingThe codes SHALL be taken from Unit of Measurement
      (required to http://ema.europa.eu/fhir/vs/unitsOfMeasurementVs)
      TypeQuantity(SimpleQuantity)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. RatioRange.highNumerator.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      This element is affected by the following invariants: ele-1
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      26. RatioRange.highNumerator.extension
      Definition

      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 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.

      ShortAdditional content defined by implementations
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on RatioRange.highNumerator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 28. RatioRange.highNumerator.value
        Definition

        The value of the measured amount. The value includes an implicit precision in the presentation of the value.

        ShortNumerical value (with implicit precision)
        Comments

        The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

        Control1..1
        Typedecimal
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Precision is handled implicitly in almost all cases of measurement.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. RatioRange.highNumerator.comparator
        Definition

        Not allowed to be used in this context

        Short< | <= | >= | > | ad - how to understand the value
        Control0..0
        BindingThe codes SHALL be taken from QuantityComparator
        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

        How the Quantity should be understood and represented.

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

        Meaning if MissingIf there is no comparator, then there is no modification of the value
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. RatioRange.highNumerator.unit
        Definition

        A human-readable form of the unit.

        ShortUnit representation
        Control1..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. RatioRange.highNumerator.system
        Definition

        The identification of the system that provides the coded form of the unit.

        ShortSystem that defines coded unit form
        Control0..1
        This element is affected by the following invariants: qty-3
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to know the system that defines the coded form of the unit.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. RatioRange.highNumerator.code
        Definition

        A computer processable form of the unit in some unit representation system.

        ShortCoded form of the unit
        Comments

        The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

        Control0..1
        This element is affected by the following invariants: qty-3
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. RatioRange.denominator
        Definition

        The value of the denominator.

        ShortDenominator value
        Control1..1
        This element is affected by the following invariants: ratrng-1
        BindingThe codes SHALL be taken from Units of Presentation
        (required to http://ema.europa.eu/fhir/vs/unitsOfPresentation)
        TypeQuantity(SimpleQuantity)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. RatioRange.denominator.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        This element is affected by the following invariants: ele-1
        Typeid
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        42. RatioRange.denominator.extension
        Definition

        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 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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on RatioRange.denominator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 44. RatioRange.denominator.value
          Definition

          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

          Control1..1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Precision is handled implicitly in almost all cases of measurement.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. RatioRange.denominator.comparator
          Definition

          Not allowed to be used in this context

          Short< | <= | >= | > | ad - how to understand the value
          Control0..0
          BindingThe codes SHALL be taken from QuantityComparator
          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

          Meaning if MissingIf there is no comparator, then there is no modification of the value
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. RatioRange.denominator.unit
          Definition

          A human-readable form of the unit.

          ShortUnit representation
          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. RatioRange.denominator.system
          Definition

          The identification of the system that provides the coded form of the unit.

          ShortSystem that defines coded unit form
          Control0..1
          This element is affected by the following invariants: qty-3
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to know the system that defines the coded form of the unit.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. RatioRange.denominator.code
          Definition

          A computer processable form of the unit in some unit representation system.

          ShortCoded form of the unit
          Comments

          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

          Control0..1
          This element is affected by the following invariants: qty-3
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))