Evidence-example-mortalitylongterm-corticosteroids.json

Corticosteroids for Patients with Sepsis with Mortality (60 days to 1 year)

{
  "resourceType": "Evidence",
  "id": "Evidence-Example-MortalityLongTerm-Corticosteroids",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: Evidence-Example-MortalityLongTerm-Corticosteroids</p><p><b>title</b>: Corticosteroids for Patients with Sepsis with Mortality (60 days to 1 year)</p><p><b>status</b>: draft</p><p><b>relatedArtifact</b>: </p><p><b>description</b>: Occurrence of Mortality with Corticosteroids for patients with sepsis</p><h3>ReferentGroups</h3><table><tr><td>-</td><td><b>Description</b></td><td><b>EvidenceSource</b></td><td><b>IntendedGroup</b></td><td><b>DirectnessMatch</b></td></tr><tr><td>*</td><td>Patients with sepsis</td><td>???</td><td>Patients with sepsis</td><td>??? <span>(Details : {http://terminology.hl7.org/CodeSystem/directness code 'null' = 'null', given as '???'})</span></td></tr></table><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: Mortality Longer term (60 days to 1 year)</p><p><b>variableRole</b>: measured variable <span>(Details : {http://terminology.hl7.org/CodeSystem/variable-role code 'measuredVariable' = 'measured variable', given as 'measured variable'})</span></p><p><b>actualDefinition</b>: many studies had shorter term outcomes</p><p><b>intendedDefinition</b>: Mortality Longer term (Follow up: 60 days to 1 year)</p><p><b>directnessMatch</b>: moderate <span>(Details : {http://terminology.hl7.org/CodeSystem/directness code 'moderate' = 'Moderate quality match', given as 'moderate'})</span></p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: Corticosteroids</p><p><b>variableRole</b>: exposure <span>(Details : {http://terminology.hl7.org/CodeSystem/variable-role code 'exposure' = 'exposure', given as 'exposure'})</span></p><p><b>actualDefinition</b>: ???</p><p><b>intendedDefinition</b>: Corticosteroids</p><p><b>directnessMatch</b>: ??? <span>(Details : {http://terminology.hl7.org/CodeSystem/directness code 'null' = 'null', given as '???'})</span></p></blockquote><p><b>synthesisType</b>: summary data meta-analysis <span>(Details : {http://terminology.hl7.org/CodeSystem/synthesis-type code 'std-MA' = 'summary data meta-analysis', given as 'summary data meta-analysis'})</span></p><p><b>studyType</b>: randomized trial <span>(Details : {http://terminology.hl7.org/CodeSystem/study-type code 'RCT' = 'randomized trial', given as 'randomized trial'})</span></p><p><b>statistic</b>: </p><blockquote><p><b>certainty</b></p><p><b>description</b>: Low, due to serious imprecision and indirectness.</p><p><b>rating</b>: Low quality <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-rating code 'low' = 'Low quality', given as 'Low quality'})</span></p><blockquote><p><b>certaintySubcomponent</b></p><p><b>note</b>: Note that all studies that reported 90 day to 1 year mortality also reported 28-30 day mortality: the CI 95% around the pooled effect for short term mortality also excludes no effect: RR 0.91 (CI 95% 0.84 - 0.98).</p><p><b>type</b>: Risk of bias <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type code 'RiskOfBias' = 'Risk of bias', given as 'Risk of bias'})</span></p><p><b>rating</b>: no serious concern <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating code 'no-concern' = 'no serious concern', given as 'no serious concern'})</span></p></blockquote><blockquote><p><b>certaintySubcomponent</b></p><p><b>type</b>: Inconsistency <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type code 'Inconsistency' = 'Inconsistency', given as 'Inconsistency'})</span></p><p><b>rating</b>: no serious concern <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating code 'no-concern' = 'no serious concern', given as 'no serious concern'})</span></p></blockquote><blockquote><p><b>certaintySubcomponent</b></p><p><b>note</b>: Only a small proportion of studies reported longer-term mortality.</p><p><b>type</b>: Indirectness <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type code 'Indirectness' = 'Indirectness', given as 'Indirectness'})</span></p><p><b>rating</b>: serious concern <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating code 'serious-concern' = 'serious concern', given as 'serious concern'})</span></p></blockquote><blockquote><p><b>certaintySubcomponent</b></p><p><b>note</b>: Confidence interval includes no effect.</p><p><b>type</b>: Imprecision <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type code 'Imprecision' = 'Imprecision', given as 'Imprecision'})</span></p><p><b>rating</b>: serious concern <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating code 'serious-concern' = 'serious concern', given as 'serious concern'})</span></p></blockquote><blockquote><p><b>certaintySubcomponent</b></p><p><b>type</b>: Publication bias <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type code 'PublicationBias' = 'Publication bias', given as 'Publication bias'})</span></p><p><b>rating</b>: no serious concern <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating code 'no-concern' = 'no serious concern', given as 'no serious concern'})</span></p></blockquote></blockquote></div>"
  },
  "title": "Corticosteroids for Patients with Sepsis with Mortality (60 days to 1 year)",
  "status": "draft",
  "relatedArtifact": [
    {
      "type": "derived-from",
      "url": "https://app.magicapp.org/public/guideline/EZ1w8n/pico/31831/widget?tab=outcome"
    }
  ],
  "description": "Occurrence of Mortality with Corticosteroids for patients with sepsis",
  "referentGroup": {
    "description": "Patients with sepsis",
    "evidenceSource": {
      "type": "Group",
      "display": "???"
    },
    "intendedGroup": {
      "type": "Group",
      "display": "Patients with sepsis"
    },
    "directnessMatch": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/directness",
          "display": "???"
        }
      ]
    }
  },
  "variableDefinition": [
    {
      "description": "Mortality Longer term (60 days to 1 year)",
      "variableRole": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/variable-role",
            "code": "measuredVariable",
            "display": "measured variable"
          }
        ]
      },
      "actualDefinition": {
        "type": "EvidenceVariable",
        "display": "many studies had shorter term outcomes"
      },
      "intendedDefinition": {
        "type": "EvidenceVariable",
        "display": "Mortality Longer term (Follow up: 60 days to 1 year)"
      },
      "directnessMatch": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/directness",
            "code": "moderate",
            "display": "moderate"
          }
        ]
      }
    },
    {
      "description": "Corticosteroids",
      "variableRole": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/variable-role",
            "code": "exposure",
            "display": "exposure"
          }
        ]
      },
      "actualDefinition": {
        "type": "EvidenceVariable",
        "display": "???"
      },
      "intendedDefinition": {
        "type": "EvidenceVariable",
        "display": "Corticosteroids"
      },
      "directnessMatch": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/directness",
            "display": "???"
          }
        ]
      }
    }
  ],
  "synthesisType": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/synthesis-type",
        "code": "std-MA",
        "display": "summary data meta-analysis"
      }
    ]
  },
  "studyType": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/study-type",
        "code": "RCT",
        "display": "randomized trial"
      }
    ]
  },
  "statistic": [
    {
      "description": "349 per 1000",
      "note": [
        {
          "text": "349 per 1000 experienced Mortality (60 days to 1 year)"
        }
      ],
      "statisticType": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/statistic-type",
            "code": "C44256",
            "display": "proportion"
          }
        ]
      },
      "quantity": {
        "value": 0.349
      },
      "sampleSize": {
        "note": [
          {
            "text": "Based on data from 6438 patients in 9 studies "
          }
        ],
        "numberOfStudies": 9,
        "numberOfParticipants": 6438
      }
    }
  ],
  "certainty": [
    {
      "description": "Low, due to serious imprecision and indirectness.",
      "rating": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/certainty-rating",
              "code": "low",
              "display": "Low quality"
            }
          ]
        }
      ],
      "certaintySubcomponent": [
        {
          "note": {
            "text": "Note that all studies that reported 90 day to 1 year mortality also reported 28-30 day mortality: the CI 95% around the pooled effect for short term mortality also excludes no effect: RR 0.91 (CI 95% 0.84 - 0.98)."
          },
          "type": [
            {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type",
                  "code": "RiskOfBias",
                  "display": "Risk of bias"
                }
              ]
            }
          ],
          "rating": [
            {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating",
                  "code": "no-concern",
                  "display": "no serious concern"
                }
              ]
            }
          ]
        },
        {
          "type": [
            {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type",
                  "code": "Inconsistency",
                  "display": "Inconsistency"
                }
              ]
            }
          ],
          "rating": [
            {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating",
                  "code": "no-concern",
                  "display": "no serious concern"
                }
              ]
            }
          ]
        },
        {
          "note": {
            "text": "Only a small proportion of studies reported longer-term mortality."
          },
          "type": [
            {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type",
                  "code": "Indirectness",
                  "display": "Indirectness"
                }
              ]
            }
          ],
          "rating": [
            {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating",
                  "code": "serious-concern",
                  "display": "serious concern"
                }
              ]
            }
          ]
        },
        {
          "note": {
            "text": "Confidence interval includes no effect."
          },
          "type": [
            {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type",
                  "code": "Imprecision",
                  "display": "Imprecision"
                }
              ]
            }
          ],
          "rating": [
            {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating",
                  "code": "serious-concern",
                  "display": "serious concern"
                }
              ]
            }
          ]
        },
        {
          "type": [
            {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type",
                  "code": "PublicationBias",
                  "display": "Publication bias"
                }
              ]
            }
          ],
          "rating": [
            {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating",
                  "code": "no-concern",
                  "display": "no serious concern"
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}