Release 5 Ballot
Clinical ReasoningThis page is part of the FHIR Specification (v5.0.0-ballot: FHIR R5 Ballot Preview). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions 
. Page versions: R5 R4B
| Clinical Decision Support Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Not linked to any defined compartments |
Raw Turtle (+ also see Turtle/RDF Format Specification)
Effect of Alteplase vs No alteplase on mRS 3-6 at 90 days in Stroke 0-3 hours prior
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
[a fhir:Evidence;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "example-stroke-0-3-alteplase-vs-no-alteplase-mRS3-6"];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>\n "Effect of Alteplase vs No alteplase on mRS 3-6 at 90 days in Stroke 0-3 hours prior" is a comparative effect estimate.\n </p>\n </div>"
];
fhir:Evidence.url [ fhir:value "http://hl7.org/fhir/Evidence/example-stroke-0-3-alteplase-vs-no-alteplase-mRS3-6"];
fhir:Evidence.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ];
fhir:Identifier.value [ fhir:value "urn:oid:2.16.840.1.113883.4.642.10.5" ]
];
fhir:Evidence.title [ fhir:value "Effect of Alteplase vs No alteplase on mRS 3-6 at 90 days in Stroke 0-3 hours prior"];
fhir:Evidence.status [ fhir:value "draft"];
fhir:Evidence.relatedArtifact [
fhir:index 0;
fhir:RelatedArtifact.type [ fhir:value "citation" ];
fhir:RelatedArtifact.label [ fhir:value "Wardlaw 2014" ];
fhir:RelatedArtifact.display [ fhir:value "Analysis 1.16 from Wardlaw 2014" ];
fhir:RelatedArtifact.citation [ fhir:value "Wardlaw JM, Murray V, Berge E, del Zoppo GJ. Thrombolysis for acute ischaemic stroke. Cochrane Database Syst Rev. 2014 Jul 29(7):CD000213. PMID 25072528" ];
fhir:RelatedArtifact.document [
fhir:Attachment.url [ fhir:value "https://doi.org/10.1002/14651858.CD000213.pub3" ]
]
];
fhir:Evidence.description [ fhir:value "mRS 3-6 at 90 days Odds Ratio 0.65 for Alteplase vs. No Alteplase in patients with acute ischemic stroke 0-3 hours prior"];
fhir:Evidence.variableDefinition [
fhir:index 0;
fhir:Evidence.variableDefinition.variableRole [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/variable-role" ];
fhir:Coding.code [ fhir:value "population" ];
fhir:Coding.display [ fhir:value "population" ]
]
];
fhir:Evidence.variableDefinition.observed [
fhir:Reference.reference [ fhir:value "EvidenceVariable/Wardlaw2014Analysis1.16.3EvidenceSet" ];
fhir:Reference.type [ fhir:value "EvidenceVariable" ];
fhir:Reference.display [ fhir:value "Wardlaw 2014 Analysis 1.16.3 Evidence set" ]
];
fhir:Evidence.variableDefinition.intended [
fhir:Reference.reference [ fhir:value "Group/AcuteIschemicStroke0-3Hours" ];
fhir:Reference.type [ fhir:value "Group" ];
fhir:Reference.display [ fhir:value "stroke at 0-3 hours" ]
]
], [
fhir:index 1;
fhir:Evidence.variableDefinition.variableRole [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/variable-role" ];
fhir:Coding.code [ fhir:value "measuredVariable" ];
fhir:Coding.display [ fhir:value "measured variable" ]
]
];
fhir:Evidence.variableDefinition.observed [
fhir:Reference.reference [ fhir:value "EvidenceVariable/example-mRS3-6-at-90days" ];
fhir:Reference.type [ fhir:value "EvidenceVariable" ];
fhir:Reference.display [ fhir:value "mRS 3-6 at 90 days" ]
];
fhir:Evidence.variableDefinition.intended [
fhir:Reference.reference [ fhir:value "EvidenceVariable/example-dead-or-dependent-90day" ];
fhir:Reference.type [ fhir:value "EvidenceVariable" ];
fhir:Reference.display [ fhir:value "Dead or functionally dependent at 90 days" ]
]
], [
fhir:index 2;
fhir:Evidence.variableDefinition.variableRole [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/variable-role" ];
fhir:Coding.code [ fhir:value "exposure" ];
fhir:Coding.display [ fhir:value "exposure" ]
]
];
fhir:Evidence.variableDefinition.observed [
fhir:Reference.reference [ fhir:value "EvidenceVariable/example-alteplase-for-stroke" ];
fhir:Reference.type [ fhir:value "EvidenceVariable" ];
fhir:Reference.display [ fhir:value "Alteplase for Stroke" ]
];
fhir:Evidence.variableDefinition.intended [
fhir:Reference.reference [ fhir:value "EvidenceVariable/example-alteplase-for-stroke" ];
fhir:Reference.type [ fhir:value "EvidenceVariable" ];
fhir:Reference.display [ fhir:value "Alteplase for Stroke" ]
]
], [
fhir:index 3;
fhir:Evidence.variableDefinition.variableRole [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/variable-role" ];
fhir:Coding.code [ fhir:value "referenceExposure" ];
fhir:Coding.display [ fhir:value "reference exposure" ]
]
];
fhir:Evidence.variableDefinition.observed [
fhir:Reference.reference [ fhir:value "EvidenceVariable/example-no-alteplase" ];
fhir:Reference.type [ fhir:value "EvidenceVariable" ];
fhir:Reference.display [ fhir:value "no alteplase" ]
];
fhir:Evidence.variableDefinition.intended [
fhir:Reference.reference [ fhir:value "EvidenceVariable/example-no-alteplase" ];
fhir:Reference.type [ fhir:value "EvidenceVariable" ];
fhir:Reference.display [ fhir:value "no alteplase" ]
]
];
fhir:Evidence.synthesisType [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/synthesis-type" ];
fhir:Coding.code [ fhir:value "std-MA" ];
fhir:Coding.display [ fhir:value "summary data meta-analysis" ]
]
];
fhir:Evidence.studyDesign [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/research-study-classifiers" ];
fhir:Coding.code [ fhir:value "SEVCO:01003" ];
fhir:Coding.display [ fhir:value "randomized assignment" ]
]
];
fhir:Evidence.statistic [
fhir:index 0;
fhir:Evidence.statistic.statisticType [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/statistic-type" ];
fhir:Coding.code [ fhir:value "C16932" ];
fhir:Coding.display [ fhir:value "Odds Ratio" ]
]
];
fhir:Evidence.statistic.quantity [
fhir:Quantity.value [ fhir:value "0.65"^^xsd:decimal ]
];
fhir:Evidence.statistic.numberOfEvents [ fhir:value "1137"^^xsd:nonNegativeInteger ];
fhir:Evidence.statistic.sampleSize [
fhir:Evidence.statistic.sampleSize.numberOfStudies [ fhir:value "6"^^xsd:nonNegativeInteger ];
fhir:Evidence.statistic.sampleSize.numberOfParticipants [ fhir:value "1779"^^xsd:nonNegativeInteger ]
];
fhir:Evidence.statistic.attributeEstimate [
fhir:index 0;
fhir:Evidence.statistic.attributeEstimate.description [ fhir:value "95% CI 0.54 to 0.80" ];
fhir:Evidence.statistic.attributeEstimate.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/attribute-estimate-type" ];
fhir:Coding.code [ fhir:value "C53324" ];
fhir:Coding.display [ fhir:value "Confidence interval" ]
]
];
fhir:Evidence.statistic.attributeEstimate.level [ fhir:value "0.95"^^xsd:decimal ];
fhir:Evidence.statistic.attributeEstimate.range [
fhir:Range.low [
fhir:Quantity.value [ fhir:value "0.54"^^xsd:decimal ]
];
fhir:Range.high [
fhir:Quantity.value [ fhir:value "0.8"^^xsd:decimal ]
]
]
], [
fhir:index 1;
fhir:Evidence.statistic.attributeEstimate.description [ fhir:value "P-value = 0.000023" ];
fhir:Evidence.statistic.attributeEstimate.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/attribute-estimate-type" ];
fhir:Coding.code [ fhir:value "C44185" ];
fhir:Coding.display [ fhir:value "P-value" ]
]
];
fhir:Evidence.statistic.attributeEstimate.quantity [
fhir:Quantity.value [ fhir:value "0.000023"^^xsd:decimal ]
]
], [
fhir:index 2;
fhir:Evidence.statistic.attributeEstimate.description [ fhir:value "Heterogeneity I-sq = 0.0%" ];
fhir:Evidence.statistic.attributeEstimate.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/attribute-estimate-type" ];
fhir:Coding.code [ fhir:value "0000420" ];
fhir:Coding.display [ fhir:value "I-squared" ]
]
];
fhir:Evidence.statistic.attributeEstimate.quantity [
fhir:Quantity.value [ fhir:value "0"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "%" ];
fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Quantity.code [ fhir:value "%" ]
]
]
];
fhir:Evidence.certainty [
fhir:index 0;
fhir:Evidence.certainty.description [ fhir:value "Moderate certainty due to risk of bias" ];
fhir:Evidence.certainty.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-type" ];
fhir:Coding.code [ fhir:value "Overall" ];
fhir:Coding.display [ fhir:value "Overall quality" ]
]
];
fhir:Evidence.certainty.rating [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-rating" ];
fhir:Coding.code [ fhir:value "moderate" ];
fhir:Coding.display [ fhir:value "Moderate" ]
]
];
fhir:Evidence.certainty.subcomponent [
fhir:index 0;
fhir:Evidence.certainty.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-type" ];
fhir:Coding.code [ fhir:value "PublicationBias" ];
fhir:Coding.display [ fhir:value "Publication bias" ]
]
];
fhir:Evidence.certainty.rating [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-rating" ];
fhir:Coding.code [ fhir:value "no-concern" ];
fhir:Coding.display [ fhir:value "no serious concern" ]
]
]
], [
fhir:index 1;
fhir:Evidence.certainty.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-type" ];
fhir:Coding.code [ fhir:value "Inconsistency" ];
fhir:Coding.display [ fhir:value "Inconsistency" ]
]
];
fhir:Evidence.certainty.rating [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-rating" ];
fhir:Coding.code [ fhir:value "no-concern" ];
fhir:Coding.display [ fhir:value "no serious concern" ]
]
]
], [
fhir:index 2;
fhir:Evidence.certainty.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-type" ];
fhir:Coding.code [ fhir:value "Imprecision" ];
fhir:Coding.display [ fhir:value "Imprecision" ]
]
];
fhir:Evidence.certainty.rating [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-rating" ];
fhir:Coding.code [ fhir:value "no-concern" ];
fhir:Coding.display [ fhir:value "no serious concern" ]
]
]
], [
fhir:index 3;
fhir:Evidence.certainty.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-type" ];
fhir:Coding.code [ fhir:value "Indirectness" ];
fhir:Coding.display [ fhir:value "Indirectness" ]
]
];
fhir:Evidence.certainty.rating [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-rating" ];
fhir:Coding.code [ fhir:value "no-concern" ];
fhir:Coding.display [ fhir:value "no serious concern" ]
]
]
], [
fhir:index 4;
fhir:Evidence.certainty.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "results largely influenced by IST-3 trial which was unblinded and NINDS trial which had allocation concealment not stated and baseline imbalances" ]
];
fhir:Evidence.certainty.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-type" ];
fhir:Coding.code [ fhir:value "RiskOfBias" ];
fhir:Coding.display [ fhir:value "Risk of bias" ]
]
];
fhir:Evidence.certainty.rating [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-rating" ];
fhir:Coding.code [ fhir:value "serious-concern" ];
fhir:Coding.display [ fhir:value "serious concern" ]
]
]
]
]] .
# - ontology header ------------------------------------------------------------
[a owl:Ontology;
owl:imports fhir:fhir.ttl] .
# -------------------------------------------------------------------------------------
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.
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