This page is part of the Evidence Based Medicine on FHIR Implementation Guide (v1.0.0-ballot: STU1 Ballot 1) based on FHIR (HL7® FHIR® Standard) v5.0.0. . For a full list of available versions, see the Directory of published versions
{
"resourceType" : "ArtifactAssessment",
"id" : "179693",
"meta" : {
"versionId" : "6",
"lastUpdated" : "2023-12-04T21:34:42.955Z",
"profile" : [
🔗 "http://hl7.org/fhir/uv/ebm/StructureDefinition/certainty-of-evidence"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ArtifactAssessment</b><a name=\"179693\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource ArtifactAssessment "179693" Version "6" Updated "2023-12-04 21:34:42+0000" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-certainty-of-evidence.html\">CertaintyOfEvidence</a></p></div><p><b>Artifact URL</b>: <a href=\"https://fevir.net/resources/ArtifactAssessment/179693\">https://fevir.net/resources/ArtifactAssessment/179693</a></p><p><b>Artifact Description</b>: This example of a CertaintyOfEvidence Profile shows a recursive pattern of component elements with type/classifier paired values for different aspects of rating the certainty of evidence.</p><p><b>identifier</b>: FEvIR Object Identifier:\u00a0179693</p><p><b>title</b>: Certainty of Evidence Rating of 14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)</p><p><b>artifact</b>: <a href=\"Evidence-55.html\">Evidence/55: 14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)</a> "Fourteen_day_mortality_remdesivir_vs_placebo_meta_analysis_ACTT_1_Wang_et_al_WHO_SOLIDARITY"</p><blockquote><p><b>content</b></p><p><b>informationType</b>: rating</p><p><b>summary</b>: Low certainty due to inconsistency and risk of bias</p><p><b>type</b>: Overall certainty <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-certainty-type.html\">Evidence Certainty Type</a>#Overall)</span></p><p><b>classifier</b>: Low quality <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-certainty-rating.html\">Evidence Certainty Rating</a>#low)</span></p><blockquote><p><b>component</b></p><p><b>informationType</b>: rating</p><p><b>type</b>: Publication bias <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-certainty-type.html\">Evidence Certainty Type</a>#PublicationBias)</span></p><p><b>classifier</b>: no serious concern <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-certainty-rating.html\">Evidence Certainty Rating</a>#no-concern)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: rating</p><p><b>summary</b>: There is a high degree of heterogeneity (I-squared = 73%). There is also inconsistency in findings between the fixed-effect and random-effects statistical models.</p><p><b>type</b>: Inconsistency <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-certainty-type.html\">Evidence Certainty Type</a>#Inconsistency)</span></p><p><b>classifier</b>: serious concern <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-certainty-rating.html\">Evidence Certainty Rating</a>#serious-concern)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: rating</p><p><b>summary</b>: Although the random-effects analysis finds an estimate without statistical significance, this imprecision is explained by the inconsistency (heterogeneity) and thus not further downrated in certainty assessment.</p><p><b>type</b>: Imprecision <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-certainty-type.html\">Evidence Certainty Type</a>#Imprecision)</span></p><p><b>classifier</b>: no serious concern <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-certainty-rating.html\">Evidence Certainty Rating</a>#no-concern)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: rating</p><p><b>type</b>: Indirectness <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-certainty-type.html\">Evidence Certainty Type</a>#Indirectness)</span></p><p><b>classifier</b>: no serious concern <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-certainty-rating.html\">Evidence Certainty Rating</a>#no-concern)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: rating</p><p><b>type</b>: Risk of bias <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-certainty-type.html\">Evidence Certainty Type</a>#RiskOfBias)</span></p><p><b>classifier</b>: serious concern <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-certainty-rating.html\">Evidence Certainty Rating</a>#serious-concern)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/artifact-url",
"valueUri" : "https://fevir.net/resources/ArtifactAssessment/179693"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/artifact-description",
"valueMarkdown" : "This example of a CertaintyOfEvidence Profile shows a recursive pattern of component elements with type/classifier paired values for different aspects of rating the certainty of evidence."
}
],
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "ACSN",
"display" : "Accession ID"
}
],
"text" : "FEvIR Object Identifier"
},
"system" : "https://fevir.net",
"value" : "179693",
"assigner" : {
"display" : "Computable Publishing LLC"
}
}
],
"title" : "Certainty of Evidence Rating of 14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)",
"artifactReference" : {
🔗 "reference" : "Evidence/55",
"type" : "Evidence",
"display" : "14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)"
},
"content" : [
{
"informationType" : "rating",
"summary" : "Low certainty due to inconsistency and risk of bias",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-type",
"code" : "Overall",
"display" : "Overall certainty"
}
]
},
"classifier" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "low",
"display" : "Low quality"
}
]
}
],
"component" : [
{
"informationType" : "rating",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-type",
"code" : "PublicationBias",
"display" : "Publication bias"
}
]
},
"classifier" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "no-concern",
"display" : "no serious concern"
}
]
}
]
},
{
"informationType" : "rating",
"summary" : "There is a high degree of heterogeneity (I-squared = 73%). There is also inconsistency in findings between the fixed-effect and random-effects statistical models.",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-type",
"code" : "Inconsistency",
"display" : "Inconsistency"
}
]
},
"classifier" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "serious-concern",
"display" : "serious concern"
}
]
}
]
},
{
"informationType" : "rating",
"summary" : "Although the random-effects analysis finds an estimate without statistical significance, this imprecision is explained by the inconsistency (heterogeneity) and thus not further downrated in certainty assessment.",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-type",
"code" : "Imprecision",
"display" : "Imprecision"
}
]
},
"classifier" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "no-concern",
"display" : "no serious concern"
}
]
}
]
},
{
"informationType" : "rating",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-type",
"code" : "Indirectness",
"display" : "Indirectness"
}
]
},
"classifier" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "no-concern",
"display" : "no serious concern"
}
]
}
]
},
{
"informationType" : "rating",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-type",
"code" : "RiskOfBias",
"display" : "Risk of bias"
}
]
},
"classifier" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "serious-concern",
"display" : "serious concern"
}
]
}
],
"component" : [
{
"informationType" : "rating",
"summary" : "No blinding (no placebo control) in the largest trial",
"type" : {
"coding" : [
{
"system" : "https://fevir.net/resources/CodeSystem/181513",
"code" : "SEVCO:00035",
"display" : "Inadequate blinding of participants"
}
],
"text" : "Lack of blinding"
},
"classifier" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "present",
"display" : "present"
}
]
}
]
}
]
}
]
}
]
}
IG © 2022+ HL7 International / Clinical Decision Support. Package hl7.fhir.uv.ebm#1.0.0-ballot based on FHIR 5.0.0. Generated 2023-12-17
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