Release 4B

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Evidence-example-stroke-0-3-alteplase-vs-no-alteplase-mRS3-6.ttl

Clinical Decision Support Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: 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 -------------------------------------------------------------------

<http://hl7.org/fhir/Evidence/example-stroke-0-3-alteplase-vs-no-alteplase-mRS3-6> 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        &quot;Effect of Alteplase vs No alteplase on mRS 3-6 at 90 days in Stroke 0-3 hours prior&quot; 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.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.useContext [
     fhir:index 0;
     fhir:UsageContext.code [
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/usage-context-type" ];
       fhir:Coding.code [ fhir:value "focus" ]
     ];
     fhir:UsageContext.valueCodeableConcept [
       fhir:CodeableConcept.text [ fhir:value "Stroke" ]
     ]
  ];
  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.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:link <http://hl7.org/fhir/EvidenceVariable/Wardlaw2014Analysis1.16.3EvidenceSet>;
       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:link <http://hl7.org/fhir/Group/AcuteIschemicStroke0-3Hours>;
       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:link <http://hl7.org/fhir/EvidenceVariable/example-mRS3-6-at-90days>;
       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:link <http://hl7.org/fhir/EvidenceVariable/example-dead-or-dependent-90day>;
       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:link <http://hl7.org/fhir/EvidenceVariable/example-alteplase-for-stroke>;
       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:link <http://hl7.org/fhir/EvidenceVariable/example-alteplase-for-stroke>;
       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:link <http://hl7.org/fhir/EvidenceVariable/example-no-alteplase>;
       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:link <http://hl7.org/fhir/EvidenceVariable/example-no-alteplase>;
       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.studyType [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/study-type" ];
       fhir:Coding.code [ fhir:value "RCT" ];
       fhir:Coding.display [ fhir:value "randomized trial" ]
     ]
  ];
  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" ]
         ]
       ]
     ]
  ] .

<http://hl7.org/fhir/EvidenceVariable/Wardlaw2014Analysis1.16.3EvidenceSet> a fhir:EvidenceVariable .

<http://hl7.org/fhir/Group/AcuteIschemicStroke0-3Hours> a fhir:Group .

<http://hl7.org/fhir/EvidenceVariable/example-mRS3-6-at-90days> a fhir:EvidenceVariable .

<http://hl7.org/fhir/EvidenceVariable/example-dead-or-dependent-90day> a fhir:EvidenceVariable .

<http://hl7.org/fhir/EvidenceVariable/example-alteplase-for-stroke> a fhir:EvidenceVariable .

<http://hl7.org/fhir/EvidenceVariable/example-no-alteplase> a fhir:EvidenceVariable .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/Evidence/example-stroke-0-3-alteplase-vs-no-alteplase-mRS3-6.ttl> a owl:Ontology;
  owl:imports fhir:fhir.ttl;
  owl:versionIRI <http://build.fhir.org/Evidence/example-stroke-0-3-alteplase-vs-no-alteplase-mRS3-6.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.