Release 5 Snapshot #1

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Systematic Meta Review (id = "citation-example-systematic-meta-review")

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  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative</b> </p> <div> <p> Resource &quot;citation-example-systematic-meta-review&quot; </p> </div> <p> <b> url</b> : <code> http://hl7.org/fhir/Citation/citation-example-systematic-meta-review</code> </p> <p> <b> identifier</b> : FEvIR Object Identifier: 27121</p> <p> <b> title</b> : SMR Sterne JAC JAMA 32876694</p> <p> <b> status</b> : active</p> <p> <b> description</b> : A systematic review included in the Steroids SMR Project</p> <p> <b> copyright</b> : https://creativecommons.org/licenses/by-nc-sa/4.0/</p> <p> <b> author</b> : Brian S. Alper: </p> <h3> Summaries</h3> <table> <tr> <td> -</td> <td> <b> Style</b> </td> <td> <b> Text</b> </td> </tr> <tr> <td> *</td> <td> Computable Publishing <span>  (citation-summary-style#comppub)</span> </td> <td> Association Between Administration of Systemic Corticosteroids and Mortality Among Critically
             Ill Patients With COVID-19: A Meta-analysis [Journal Article]. Contributors: The WHO Rapid
             Evidence Appraisal for COVID-19 Therapies (REACT) Working Group Authors and Members of
             the Writing Committee: Jonathan A. C. Sterne, MA, MSc, PhD; Srinivas Murthy, MD, MSc;
             Janet V. Diaz, MD; Arthur S. Slutsky, CM, MD; Jesús Villar, MD, PhD; Derek C. Angus,
             MD, MPH; Djillali Annane, MD, PhD; Luciano Cesar Pontes Azevedo, MD, PhD; Otavio Berwanger,
             MD, PhD; Alexandre B. Cavalcanti, MD, PhD; Pierre-Francois Dequin, MD, PhD; Bin Du, MD;
             Jonathan Emberson, PhD; David Fisher, MSc; Bruno Giraudeau, PhD; Anthony C. Gordon, MBBS,
             MD; Anders Granholm, MD; Cameron Green, MSc; Richard Haynes, DM; Nicholas Heming, MD,
             PhD; Julian P. T. Higgins, BA, PhD; Peter Horby, PhD; Peter Jüni, MD; Martin J. Landray,
             PhD; Amelie Le Gouge, MSc; Marie Leclerc, MSc; Wei Shen Lim, BMedSci, BMBS, DM; Flávia
             R. Machado, MD, PhD; Colin McArthur, MBChB; Ferhat Meziani, MD, PhD; Morten Hylander Møller,
             MD, PhD; Anders Perner, MD, PhD; Marie Warrer Petersen, MD; Jelena Savović, BPharm, MSc,
             PhD; Bruno Tomazini, MD; Viviane C. Veiga, MD, PhD; Steve Webb, MBBS, MPH, PhD; John C.
             Marshall, MD. In: JAMA, PMID 32876694. Accessed February 15, 2021. Available at: http://doi.org/10.1
            001/jama.2020.17023.</td> </tr> </table> <h3> Classifications</h3> <table> <tr> <td> -</td> <td> <b> Type</b> </td> <td> <b> Classifier</b> </td> </tr> <tr> <td> *</td> <td> FEvIR Platform Use <span>  (<a> CitationClassificationType</a> #fevir-platform-use)</span> </td> <td> Project Specific <span>  (<a> CitationArtifactClassifier</a> #project-specific)</span> </td> </tr> </table> <blockquote> <p> <b> statusDate</b> </p> <p> <b> activity</b> : ROB assessment <span>  ()</span> </p> <p> <b> actual</b> : true</p> <p> <b> period</b> : ?? --&gt; 2021-06-07</p> </blockquote> <blockquote> <p> <b> statusDate</b> </p> <p> <b> activity</b> : Author contact <span>  ()</span> </p> <p> <b> actual</b> : true</p> <p> <b> period</b> : 2021-06-07 --&gt; (ongoing)</p> </blockquote> <blockquote> <p> <b> citedArtifact</b> </p> <p> <b> identifier</b> : id: 32876694, pii: 2770279, id: 10.1001/jama.2020.17023, id: PMC7489434</p> <p> <b> relatedIdentifier</b> : id: CRD42020197242</p> <p> <b> dateAccessed</b> : 2021-02-15</p> <h3> Titles</h3> <table> <tr> <td> -</td> <td> <b> Type</b> </td> <td> <b> Language</b> </td> <td> <b> Text</b> </td> </tr> <tr> <td> *</td> <td> primary-human-use <span>  ()</span> </td> <td> English <span>  (<a> Tags for the Identification of Languages</a> #en)</span> </td> <td> Association Between Administration of Systemic Corticosteroids and Mortality Among Critically
               Ill Patients With COVID-19: A Meta-analysis.</td> </tr> </table> <h3> Abstracts</h3> <table> <tr> <td> -</td> <td> <b> Type</b> </td> <td> <b> Text</b> </td> </tr> <tr> <td> *</td> <td> Primary human use <span>  (<a> CitedArtifactAbstractType</a> #primary-human-use)</span> </td> <td> &lt;AbstractText Label=&quot;Importance&quot;&gt;Effective therapies for patients with
               coronavirus disease 2019 (COVID-19) are needed, and clinical trial data have demonstrated
               that low-dose dexamethasone reduced mortality in hospitalized patients with COVID-19 who
               required respiratory support.&lt;/AbstractText&gt;&lt;AbstractText Label=&quot;Objective&quot;&gt;To
               estimate the association between administration of corticosteroids compared with usual
               care or placebo and 28-day all-cause mortality.&lt;/AbstractText&gt;&lt;AbstractText Label=&quot;Des
              ign, Setting, and Participants&quot;&gt;Prospective meta-analysis that pooled data from
               7 randomized clinical trials that evaluated the efficacy of corticosteroids in 1703 critically
               ill patients with COVID-19. The trials were conducted in 12 countries from February 26,
               2020, to June 9, 2020, and the date of final follow-up was July 6, 2020. Pooled data were
               aggregated from the individual trials, overall, and in predefined subgroups. Risk of bias
               was assessed using the Cochrane Risk of Bias Assessment Tool. Inconsistency among trial
               results was assessed using the I2 statistic. The primary analysis was an inverse variance-weighted
               fixed-effect meta-analysis of overall mortality, with the association between the intervention
               and mortality quantified using odds ratios (ORs). Random-effects meta-analyses also were
               conducted (with the Paule-Mandel estimate of heterogeneity and the Hartung-Knapp adjustment)
               and an inverse variance-weighted fixed-effect analysis using risk ratios.&lt;/AbstractText&gt;&lt;Ab
              stractText Label=&quot;Exposures&quot;&gt;Patients had been randomized to receive systemic
               dexamethasone, hydrocortisone, or methylprednisolone (678 patients) or to receive usual
               care or placebo (1025 patients).&lt;/AbstractText&gt;&lt;AbstractText Label=&quot;Main
               Outcomes and Measures&quot;&gt;The primary outcome measure was all-cause mortality at
               28 days after randomization. A secondary outcome was investigator-defined serious adverse
               events.&lt;/AbstractText&gt;&lt;AbstractText Label=&quot;Results&quot;&gt;A total of 1703
               patients (median age, 60 years [interquartile range, 52-68 years]; 488 [29%] women) were
               included in the analysis. Risk of bias was assessed as &quot;low&quot; for 6 of the 7
               mortality results and as &quot;some concerns&quot; in 1 trial because of the randomization
               method. Five trials reported mortality at 28 days, 1 trial at 21 days, and 1 trial at
               30 days. There were 222 deaths among the 678 patients randomized to corticosteroids and
               425 deaths among the 1025 patients randomized to usual care or placebo (summary OR, 0.66
               [95% CI, 0.53-0.82]; P &lt; .001 based on a fixed-effect meta-analysis). There was little
               inconsistency between the trial results (I2 = 15.6%; P = .31 for heterogeneity) and the
               summary OR was 0.70 (95% CI, 0.48-1.01; P = .053) based on the random-effects meta-analysis.
               The fixed-effect summary OR for the association with mortality was 0.64 (95% CI, 0.50-0.82;
               P &lt; .001) for dexamethasone compared with usual care or placebo (3 trials, 1282 patients,
               and 527 deaths), the OR was 0.69 (95% CI, 0.43-1.12; P = .13) for hydrocortisone (3 trials,
               374 patients, and 94 deaths), and the OR was 0.91 (95% CI, 0.29-2.87; P = .87) for methylprednisolon
              e (1 trial, 47 patients, and 26 deaths). Among the 6 trials that reported serious adverse
               events, 64 events occurred among 354 patients randomized to corticosteroids and 80 events
               occurred among 342 patients randomized to usual care or placebo.&lt;/AbstractText&gt;&lt;AbstractTex
              t Label=&quot;Conclusions and Relevance&quot;&gt;In this prospective meta-analysis of clinical
               trials of critically ill patients with COVID-19, administration of systemic corticosteroids,
               compared with usual care or placebo, was associated with lower 28-day all-cause mortality.&lt;/Abstr
              actText&gt;</td> </tr> </table> <blockquote> <p> <b> publicationForm</b> </p> <h3> PublishedIns</h3> <table> <tr> <td> -</td> <td> <b> Type</b> </td> <td> <b> Identifier</b> </td> <td> <b> Title</b> </td> <td> <b> PublisherLocation</b> </td> </tr> <tr> <td> *</td> <td> Periodical <span>  (<a> PublishedInType</a> #D020492)</span> </td> <td> ISSN Type: 1538-3598, ISOAbbreviation: JAMA, ISSN Linking: 0098-7484, Medline Title Abbreviation:
                 JAMA, NLM Unique ID: 7501160</td> <td> JAMA</td> <td> United States</td> </tr> </table> <blockquote> <p> <b> periodicRelease</b> </p> <p> <b> citedMedium</b> : Internet <span>  (journal-issue-medium#Internet)</span> </p> <p> <b> volume</b> : 324</p> <p> <b> issue</b> : 13</p> <h3> DateOfPublications</h3> <table> <tr> <td> -</td> <td> <b> Date</b> </td> <td> <b> Year</b> </td> <td> <b> Month</b> </td> <td> <b> Day</b> </td> </tr> <tr> <td> *</td> <td> 2020-10-06</td> <td> 2020</td> <td> 10</td> <td> 06</td> </tr> </table> </blockquote> <p> <b> language</b> : English <span>  (<a> Tags for the Identification of Languages</a> #en)</span> </p> <p> <b> pageString</b> : 1330-1341</p> </blockquote> <blockquote> <p> <b> webLocation</b> </p> <p> <b> classifier</b> : DOI Based <span>  (<a> ArtifactUrlClassifier</a> #doi-based)</span> </p> <p> <b> url</b> : <a> http://doi.org/10.1001/jama.2020.17023</a> </p> </blockquote> <blockquote> <p> <b> webLocation</b> </p> <p> <b> classifier</b> : on PubMed <span>  (<a> ArtifactUrlClassifier[5.0.0-snapshot1]</a> #abstract &quot;Abstract&quot;)</span> </p> <p> <b> url</b> : <a> https://pubmed.ncbi.nlm.nih.gov/32876694/</a> </p> </blockquote> <blockquote> <p> <b> webLocation</b> </p> <p> <b> classifier</b> : on JAMA <span>  (<a> ArtifactUrlClassifier[5.0.0-snapshot1]</a> #full-text &quot;Full-Text&quot;)</span> </p> <p> <b> url</b> : <a> https://jamanetwork.com/journals/jama/fullarticle/2770279</a> </p> </blockquote> <blockquote> <p> <b> classification</b> </p> <p> <b> type</b> : Steroids SMR project use <span>  ()</span> </p> <p> <b> classifier</b> : primary article <span>  ()</span> , Unclear risk of bias <span>  ()</span> </p> <h3> WhoClassifieds</h3> <table> <tr> <td> -</td> <td> <b> Person</b> </td> <td> <b> FreeToShare</b> </td> </tr> <tr> <td> *</td> <td> <span> : Brian S. Alper</span> </td> <td> false</td> </tr> </table> </blockquote> <blockquote> <p> <b> classification</b> </p> <p> <b> type</b> : UC Description <span>  ()</span> </p> <p> <b> classifier</b> : To assess systemic corticosteroids on 28-day mortality in critically ill patients with
             COVID-19 <span>  ()</span> </p> <h3> WhoClassifieds</h3> <table> <tr> <td> -</td> <td> <b> Person</b> </td> <td> <b> Organization</b> </td> <td> <b> FreeToShare</b> </td> </tr> <tr> <td> *</td> <td> <span> : Dr. Ethan Molitch</span> </td> <td> <span> : University of Chicago</span> </td> <td> true</td> </tr> </table> </blockquote> <blockquote> <p> <b> classification</b> </p> <p> <b> type</b> : Knowledge Artifact Type <span>  (<a> CitedArtifactClassificationType</a> #knowledge-artifact-type)</span> </p> <p> <b> classifier</b> : Journal Article <span>  (<a> CitationArtifactClassifier</a> #D016428)</span> </p> <h3> WhoClassifieds</h3> <table> <tr> <td> -</td> <td> <b> Publisher</b> </td> <td> <b> ClassifierCopyright</b> </td> <td> <b> FreeToShare</b> </td> </tr> <tr> <td> *</td> <td> <span> : Computable Publishing LLC</span> </td> <td> https://creativecommons.org/licenses/by-nc-sa/4.0</td> <td> true</td> </tr> </table> </blockquote> <blockquote> <p> <b> classification</b> </p> <p> <b> type</b> : Publishing Model <span>  (<a> CitedArtifactClassificationType</a> #publishing-model)</span> </p> <p> <b> classifier</b> : Print <span>  (<a> CitationArtifactClassifier</a> #Print)</span> </p> </blockquote> <blockquote> <p> <b> classification</b> </p> <p> <b> type</b> : Chemical <span>  (<a> CitedArtifactClassificationType</a> #chemical)</span> </p> <p> <b> classifier</b> : Adrenal Cortex Hormones <span>  (chemical-substances#0; #D000305)</span> , Glucocorticoids <span>  (chemical-substances#0; #D005938)</span> , Dexamethasone <span>  (chemical-substances#7S5I7G3JQL; #D003907)</span> , Hydrocortisone <span>  (chemical-substances#WI4X0X7BPJ; #D006854)</span> , Methylprednisolone <span>  (chemical-substances#X4W7ZR7023; #D008775)</span> </p> </blockquote> <blockquote> <p> <b> classification</b> </p> <p> <b> type</b> : MeSH heading <span>  (<a> CitedArtifactClassificationType</a> #mesh-heading)</span> </p> <p> <b> classifier</b> : Adrenal Cortex Hormones <span>  (#D000305; #Q000627 &quot;therapeutic use&quot;; [not stated]#Y)</span> , Betacoronavirus <span>  (#D000073640)</span> , COVID-19 <span>  (#D000086382)</span> , Cause of Death <span>  (#D002423)</span> , Coronavirus Infections <span>  (#D018352; #Q000188 &quot;drug therapy&quot;; [not stated]#Y; #Q000401 &quot;mortality&quot;;
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               [not stated]#N)</span> , Randomized Controlled Trials as Topic <span>  (#D016032)</span> , SARS-CoV-2 <span>  (#D000086402)</span> </p> </blockquote> <blockquote> <p> <b> classification</b> </p> <p> <b> type</b> : Publication type <span>  (<a> CitedArtifactClassificationType</a> #publication-type)</span> </p> <p> <b> classifier</b> : Journal Article <span>  (#D016428)</span> , Meta-Analysis <span>  (#D017418)</span> , Research Support, Non-U.S. Gov't <span>  (#D013485)</span> </p> </blockquote> <blockquote> <p> <b> classification</b> </p> <p> <b> type</b> : Supplemental MeSH for Protocol <span>  (<a> CitedArtifactClassificationType</a> #supplemental-mesh-protocol)</span> </p> <p> <b> classifier</b> : COVID-19 drug treatment <span>  (#C000705127)</span> </p> </blockquote> <blockquote> <p> <b> classification</b> </p> <p> <b> type</b> : Citation subset <span>  (<a> CitedArtifactClassificationType</a> #citation-subset)</span> </p> <p> <b> classifier</b> : AIM <span>  (elements_descriptions.html#citationsubset#AIM)</span> , IM <span>  (elements_descriptions.html#citationsubset#IM)</span> </p> </blockquote> <blockquote> <p> <b> classification</b> </p> <p> <b> type</b> : Funding <span>  ()</span> </p> <p> <b> classifier</b> : The World Health Organization (Conflict of interest statements included notes on several
             fundings for co-investigators as well, albeit not directly funding this meta-analysis)
             <span>  ()</span> </p> <h3> WhoClassifieds</h3> <table> <tr> <td> -</td> <td> <b> Person</b> </td> <td> <b> Organization</b> </td> <td> <b> FreeToShare</b> </td> </tr> <tr> <td> *</td> <td> <span> : Erfan Shamsoddin</span> </td> <td> <span> : COVID-19 Knowledge Accelerator</span> </td> <td> true</td> </tr> </table> </blockquote> <blockquote> <p> <b> contributorship</b> </p> <p> <b> complete</b> : true</p> <blockquote> <p> <b> entry</b> </p> <p> <b> collectiveName</b> : WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group</p> </blockquote> <blockquote> <p> <b> entry</b> </p> <p> <b> name</b> : Jonathan A C Sterne </p> <p> <b> initials</b> : JAC</p> <blockquote> <p> <b> affiliationInfo</b> </p> <p> <b> affiliation</b> : Population Health Sciences, Bristol Medical School, University of Bristol, Bristol,
                 England.</p> </blockquote> <blockquote> <p> <b> affiliationInfo</b> </p> <p> <b> affiliation</b> : NIHR Bristol Biomedical Research Centre, Bristol, England.</p> </blockquote> <p> <b> telecom</b> : <a> jonathan.sterne@bristol.ac.uk</a> </p> <p> <b> correspondingContact</b> : true</p> </blockquote> <blockquote> <p> <b> entry</b> </p> <p> <b> name</b> : Srinivas Murthy </p> <p> <b> initials</b> : S</p> <h3> AffiliationInfos</h3> <table> <tr> <td> -</td> <td> <b> Affiliation</b> </td> </tr> <tr> <td> *</td> <td> Department of Pediatrics, University of British Columbia, Vancouver, Canada.</td> </tr> </table> </blockquote> <blockquote> <p> <b> entry</b> </p> <p> <b> name</b> : Janet V Diaz </p> <p> <b> initials</b> : JV</p> <h3> AffiliationInfos</h3> <table> <tr> <td> -</td> <td> <b> Affiliation</b> </td> </tr> <tr> <td> *</td> <td> Clinical Unit, Health Emergencies Programme, World Health Organization, Geneva, Switzerland.</td> </tr> </table> </blockquote> <blockquote> <p> <b> entry</b> </p> <p> <b> name</b> : Arthur S Slutsky </p> <p> <b> initials</b> : AS</p> <h3> AffiliationInfos</h3> <table> <tr> <td> -</td> <td> <b> Affiliation</b> </td> </tr> <tr> <td> *</td> <td> Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital,
                   Department of Medicine, University of Toronto, Toronto, Ontario, Canada.</td> </tr> </table> </blockquote> <blockquote> <p> <b> entry</b> </p> <p> <b> name</b> : Jesús Villar </p> <p> <b> initials</b> : J</p> <blockquote> <p> <b> affiliationInfo</b> </p> <p> <b> affiliation</b> : Research Unit, Hospital Universitario Dr Negrín, Las Palmas de Gran Canaria, Spain.</p> </blockquote> <blockquote> <p> <b> affiliationInfo</b> </p> <p> <b> affiliation</b> : CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.</p> </blockquote> </blockquote> <blockquote> <p> <b> entry</b> </p> <p> <b> name</b> : Derek C Angus </p> <p> <b> initials</b> : DC</p> <h3> AffiliationInfos</h3> <table> <tr> <td> -</td> <td> <b> Affiliation</b> </td> </tr> <tr> <td> *</td> <td> Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh,
                   Pennsylvania.</td> </tr> </table> </blockquote> <blockquote> <p> <b> entry</b> </p> <p> <b> name</b> : Djillali Annane </p> <p> <b> initials</b> : D</p> <h3> AffiliationInfos</h3> <table> <tr> <td> -</td> <td> <b> Affiliation</b> </td> </tr> <tr> <td> *</td> <td> Department of Intensive Care, Raymond Poincaré Hospital (APHP), School of Medicine Simone
                   Veil, University Paris Saclay-UVSQ, Paris, France.</td> </tr> </table> </blockquote> <blockquote> <p> <b> entry</b> </p> <p> <b> name</b> : Luciano Cesar Pontes Azevedo </p> <p> <b> initials</b> : LCP</p> <blockquote> <p> <b> affiliationInfo</b> </p> <p> <b> affiliation</b> : Hospital Sírio-Libanês, São Paulo, Brazil.</p> </blockquote> <blockquote> <p> <b> affiliationInfo</b> </p> <p> <b> affiliation</b> : Emergency Medicine Department, University of São Paulo School of Medicine, São Paulo,
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                   Ontario, Canada.</td> </tr> </table> </blockquote> <h3> Summaries</h3> <table> <tr> <td> -</td> <td> <b> Type</b> </td> <td> <b> Source</b> </td> <td> <b> Value</b> </td> </tr> <tr> <td> *</td> <td> Author string <span>  (<a> ContributorSummaryType[5.0.0-snapshot1]</a> #author-string)</span> </td> <td> articleCopy <span>  ()</span> </td> <td> The WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group Authors
                 and Members of the Writing Committee: Jonathan A. C. Sterne, MA, MSc, PhD; Srinivas Murthy,
                 MD, MSc; Janet V. Diaz, MD; Arthur S. Slutsky, CM, MD; Jesús Villar, MD, PhD; Derek C.
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     Evidence Appraisal for COVID-19 Therapies (REACT) Working Group Authors and Members of
     the Writing Committee: Jonathan A. C. Sterne, MA, MSc, PhD; Srinivas Murthy, MD, MSc;
     Janet V. Diaz, MD; Arthur S. Slutsky, CM, MD; Jesús Villar, MD, PhD; Derek C. Angus,
     MD, MPH; Djillali Annane, MD, PhD; Luciano Cesar Pontes Azevedo, MD, PhD; Otavio Berwanger,
     MD, PhD; Alexandre B. Cavalcanti, MD, PhD; Pierre-Francois Dequin, MD, PhD; Bin Du, MD;
     Jonathan Emberson, PhD; David Fisher, MSc; Bruno Giraudeau, PhD; Anthony C. Gordon, MBBS,
     MD; Anders Granholm, MD; Cameron Green, MSc; Richard Haynes, DM; Nicholas Heming, MD,
     PhD; Julian P. T. Higgins, BA, PhD; Peter Horby, PhD; Peter Jüni, MD; Martin J. Landray,
     PhD; Amelie Le Gouge, MSc; Marie Leclerc, MSc; Wei Shen Lim, BMedSci, BMBS, DM; Flávia
     R. Machado, MD, PhD; Colin McArthur, MBChB; Ferhat Meziani, MD, PhD; Morten Hylander Møller,
     MD, PhD; Anders Perner, MD, PhD; Marie Warrer Petersen, MD; Jelena Savović, BPharm, MSc,
     PhD; Bruno Tomazini, MD; Viviane C. Veiga, MD, PhD; Steve Webb, MBBS, MPH, PhD; John C.
     Marshall, MD. In: JAMA, PMID 32876694. Accessed February 15, 2021. Available at: http://doi.org/10.1
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      <text value="Association Between Administration of Systemic Corticosteroids and Mortality Among Critically
       Ill Patients With COVID-19: A Meta-analysis."/> 
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      <text value="&lt;AbstractText Label=&quot;Importance&quot;&gt;Effective therapies for patients with
       coronavirus disease 2019 (COVID-19) are needed, and clinical trial data have demonstrated
       that low-dose dexamethasone reduced mortality in hospitalized patients with COVID-19 who
       required respiratory support.&lt;/AbstractText&gt;&lt;AbstractText Label=&quot;Objective&quot;&gt;To
       estimate the association between administration of corticosteroids compared with usual
       care or placebo and 28-day all-cause mortality.&lt;/AbstractText&gt;&lt;AbstractText Label=&quot;Des
      ign, Setting, and Participants&quot;&gt;Prospective meta-analysis that pooled data from
       7 randomized clinical trials that evaluated the efficacy of corticosteroids in 1703 critically
       ill patients with COVID-19. The trials were conducted in 12 countries from February 26,
       2020, to June 9, 2020, and the date of final follow-up was July 6, 2020. Pooled data were
       aggregated from the individual trials, overall, and in predefined subgroups. Risk of bias
       was assessed using the Cochrane Risk of Bias Assessment Tool. Inconsistency among trial
       results was assessed using the I2 statistic. The primary analysis was an inverse variance-weighted
       fixed-effect meta-analysis of overall mortality, with the association between the intervention
       and mortality quantified using odds ratios (ORs). Random-effects meta-analyses also were
       conducted (with the Paule-Mandel estimate of heterogeneity and the Hartung-Knapp adjustment)
       and an inverse variance-weighted fixed-effect analysis using risk ratios.&lt;/AbstractText&gt;&lt;Ab
      stractText Label=&quot;Exposures&quot;&gt;Patients had been randomized to receive systemic
       dexamethasone, hydrocortisone, or methylprednisolone (678 patients) or to receive usual
       care or placebo (1025 patients).&lt;/AbstractText&gt;&lt;AbstractText Label=&quot;Main
       Outcomes and Measures&quot;&gt;The primary outcome measure was all-cause mortality at
       28 days after randomization. A secondary outcome was investigator-defined serious adverse
       events.&lt;/AbstractText&gt;&lt;AbstractText Label=&quot;Results&quot;&gt;A total of 1703
       patients (median age, 60 years [interquartile range, 52-68 years]; 488 [29%] women) were
       included in the analysis. Risk of bias was assessed as &quot;low&quot; for 6 of the 7
       mortality results and as &quot;some concerns&quot; in 1 trial because of the randomization
       method. Five trials reported mortality at 28 days, 1 trial at 21 days, and 1 trial at
       30 days. There were 222 deaths among the 678 patients randomized to corticosteroids and
       425 deaths among the 1025 patients randomized to usual care or placebo (summary OR, 0.66
       [95% CI, 0.53-0.82]; P &lt; .001 based on a fixed-effect meta-analysis). There was little
       inconsistency between the trial results (I2 = 15.6%; P = .31 for heterogeneity) and the
       summary OR was 0.70 (95% CI, 0.48-1.01; P = .053) based on the random-effects meta-analysis.
       The fixed-effect summary OR for the association with mortality was 0.64 (95% CI, 0.50-0.82;
       P &lt; .001) for dexamethasone compared with usual care or placebo (3 trials, 1282 patients,
       and 527 deaths), the OR was 0.69 (95% CI, 0.43-1.12; P = .13) for hydrocortisone (3 trials,
       374 patients, and 94 deaths), and the OR was 0.91 (95% CI, 0.29-2.87; P = .87) for methylprednisolon
      e (1 trial, 47 patients, and 26 deaths). Among the 6 trials that reported serious adverse
       events, 64 events occurred among 354 patients randomized to corticosteroids and 80 events
       occurred among 342 patients randomized to usual care or placebo.&lt;/AbstractText&gt;&lt;AbstractTex
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         and Members of the Writing Committee: Jonathan A. C. Sterne, MA, MSc, PhD; Srinivas Murthy,
         MD, MSc; Janet V. Diaz, MD; Arthur S. Slutsky, CM, MD; Jesús Villar, MD, PhD; Derek C.
         Angus, MD, MPH; Djillali Annane, MD, PhD; Luciano Cesar Pontes Azevedo, MD, PhD; Otavio
         Berwanger, MD, PhD; Alexandre B. Cavalcanti, MD, PhD; Pierre-Francois Dequin, MD, PhD;
         Bin Du, MD; Jonathan Emberson, PhD; David Fisher, MSc; Bruno Giraudeau, PhD; Anthony C.
         Gordon, MBBS, MD; Anders Granholm, MD; Cameron Green, MSc; Richard Haynes, DM; Nicholas
         Heming, MD, PhD; Julian P. T. Higgins, BA, PhD; Peter Horby, PhD; Peter Jüni, MD; Martin
         J. Landray, PhD; Amelie Le Gouge, MSc; Marie Leclerc, MSc; Wei Shen Lim, BMedSci, BMBS,
         DM; Flávia R. Machado, MD, PhD; Colin McArthur, MBChB; Ferhat Meziani, MD, PhD; Morten
         Hylander Møller, MD, PhD; Anders Perner, MD, PhD; Marie Warrer Petersen, MD; Jelena Savović,
         BPharm, MSc, PhD; Bruno Tomazini, MD; Viviane C. Veiga, MD, PhD; Steve Webb, MBBS, MPH,
         PhD; John C. Marshall, MD."/> 
      </summary> 
    </contributorship> 
  </citedArtifact> 
</Citation> 

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.