Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot - ballot
Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot - ballot
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
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<versionId value="6"/>
<lastUpdated value="2023-12-04T21:34:42.955Z"/>
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value="http://hl7.org/fhir/uv/ebm/StructureDefinition/certainty-of-evidence"/>
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<text>
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<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: 179693</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>
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<valueMarkdown
value="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."/>
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<value value="179693"/>
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<display value="Computable Publishing LLC"/>
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<title
value="Certainty of Evidence Rating of 14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)"/>
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<reference value="Evidence/55"/>
<type value="Evidence"/>
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value="14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)"/>
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<content>
<informationType value="rating"/>
<summary value="Low certainty due to inconsistency and risk of bias"/>
<type>
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<system value="http://hl7.org/fhir/certainty-type"/>
<code value="Overall"/>
<display value="Overall certainty"/>
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<classifier>
<coding>
<system value="http://hl7.org/fhir/certainty-rating"/>
<code value="low"/>
<display value="Low quality"/>
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<component>
<informationType value="rating"/>
<type>
<coding>
<system value="http://hl7.org/fhir/certainty-type"/>
<code value="PublicationBias"/>
<display value="Publication bias"/>
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<classifier>
<coding>
<system value="http://hl7.org/fhir/certainty-rating"/>
<code value="no-concern"/>
<display value="no serious concern"/>
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<component>
<informationType value="rating"/>
<summary
value="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 value="http://hl7.org/fhir/certainty-type"/>
<code value="Inconsistency"/>
<display value="Inconsistency"/>
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<classifier>
<coding>
<system value="http://hl7.org/fhir/certainty-rating"/>
<code value="serious-concern"/>
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<component>
<informationType value="rating"/>
<summary
value="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 value="http://hl7.org/fhir/certainty-type"/>
<code value="Imprecision"/>
<display value="Imprecision"/>
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<classifier>
<coding>
<system value="http://hl7.org/fhir/certainty-rating"/>
<code value="no-concern"/>
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<component>
<informationType value="rating"/>
<type>
<coding>
<system value="http://hl7.org/fhir/certainty-type"/>
<code value="Indirectness"/>
<display value="Indirectness"/>
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<classifier>
<coding>
<system value="http://hl7.org/fhir/certainty-rating"/>
<code value="no-concern"/>
<display value="no serious concern"/>
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<component>
<informationType value="rating"/>
<type>
<coding>
<system value="http://hl7.org/fhir/certainty-type"/>
<code value="RiskOfBias"/>
<display value="Risk of bias"/>
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<classifier>
<coding>
<system value="http://hl7.org/fhir/certainty-rating"/>
<code value="serious-concern"/>
<display value="serious concern"/>
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<component>
<informationType value="rating"/>
<summary
value="No blinding (no placebo control) in the largest trial"/>
<type>
<coding>
<system value="https://fevir.net/resources/CodeSystem/181513"/>
<code value="SEVCO:00035"/>
<display value="Inadequate blinding of participants"/>
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<text value="Lack of blinding"/>
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<classifier>
<coding>
<system value="http://hl7.org/fhir/certainty-rating"/>
<code value="present"/>
<display value="present"/>
</coding>
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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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