ComparativeEvidenceReport: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort) - TTL Representation - Evidence Based Medicine on FHIR Implementation Guide v1.0.0-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
: ComparativeEvidenceReport: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort) - TTL Representation

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@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 -------------------------------------------------------------------

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fhir:lastUpdated [ fhir:v "2023-12-06T16:25:43.377Z"^^xsd:dateTime ] ;
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/uv/ebm/StructureDefinition/comparative-evidence-report"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/uv/ebm/StructureDefinition/comparative-evidence-report>     ] )
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fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Composition</b><a name=\"178426\"> </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 Composition &quot;178426&quot; Version &quot;52&quot; Updated &quot;2023-12-06 16:25:43+0000&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-comparative-evidence-report.html\">ComparativeEvidenceReport</a></p></div><p><b>Artifact Description</b>: This example of a ComparativeEvidenceReport Profile shows a report from a single observational study with 2 baseline measures, 2 participant flow measures, and 4 outcome measures.</p><p><b>url</b>: <a href=\"https://fevir.net/resources/Composition/178426\">https://fevir.net/resources/Composition/178426</a></p><p><b>identifier</b>: FEvIR Object Identifier: 178426</p><p><b>status</b>: final</p><p><b>type</b>: EvidenceReport <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-179423.html\">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#EvidenceReport)</span></p><p><b>category</b>: Comparative Evidence Report <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-179423.html\">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#ComparativeEvidenceReport &quot;ComparativeEvidenceReport&quot;)</span></p><p><b>date</b>: 2023-12-06 16:25:43+0000</p><p><b>author</b>: </p><ul><li><span>: Brian S. Alper</span></li><li><span>: Khalid Shahin</span></li><li><span>: Joanne Dehnbostel</span></li></ul><p><b>title</b>: ComparativeEvidenceReport: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort)</p><p><b>custodian</b>: <a href=\"Organization-118079.html\">Organization/118079: Computable Publishing LLC</a> &quot;Computable_Publishing_LLC&quot;</p><h3>RelatesTos</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Citation</b></td><td><b>ResourceReference</b></td></tr><tr><td style=\"display: none\">*</td><td>cite-as</td><td>ComparativeEvidenceReport: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort) [Composition]. Contributors: Brian S. Alper, Khalid Shahin, Joanne Dehnbostel [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 178426. Revised 2023-12-04. Available at: https://fevir.net/resources/Composition/178426. Computable resource at: https://fevir.net/resources/Composition/178426.</td><td> </td></tr><tr><td style=\"display: none\">*</td><td>derived-from</td><td> </td><td><a href=\"Citation-104116.html\">Citation/104116: JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort</a></td></tr></table></div>"
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fhir:code [ fhir:v "ComparativeEvidenceReport" ] ;
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fhir:display [ fhir:v "Brian S. Alper" ]
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fhir:display [ fhir:v "Khalid Shahin" ]
  ] [
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  fhir:title [ fhir:v "ComparativeEvidenceReport: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort)"] ; # 
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fhir:citation [ fhir:v "ComparativeEvidenceReport: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort) [Composition]. Contributors: Brian S. Alper, Khalid Shahin, Joanne Dehnbostel [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 178426. Revised 2023-12-04. Available at: https://fevir.net/resources/Composition/178426. Computable resource at: https://fevir.net/resources/Composition/178426." ]
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fhir:display [ fhir:v "JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort" ]     ]
  ] ) ; # 
  fhir:section ( [
fhir:title [ fhir:v "Population" ] ;
fhir:code [
      ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
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fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\"><b>Severely Obese Adults 2018 Norwegian Cohort</b><br/>Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (n = 2109) with severe obesity assessed (221 patients excluded and 1888 patients included).</div>"     ] ;
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fhir:display [ fhir:v "StudyGroup: Severely Obese Adults 2018 Norwegian Cohort" ]     ] )
  ] [
fhir:title [ fhir:v "Intervention" ] ;
fhir:code [
      ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
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fhir:display [ fhir:v "Intervention" ]       ] ) ;
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fhir:code [ fhir:v "intervention-description" ] ;
fhir:display [ fhir:v "Intervention Description" ]         ] ) ;
fhir:text [ fhir:v "Intervention Description" ]       ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Bariatric surgery, mostly gastric bypass (92%) or sleeve gastrectomy (7%)</div>"       ] ;
      ( fhir:entry [
fhir:reference [ fhir:v "Group/172423" ] ;
fhir:type [ fhir:v "Group"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ExposureDefinition: Bariatric Surgery (RYGB, VSG, LAGB, BPD)" ]       ] )     ] [
fhir:title [ fhir:v "Intervention Group" ] ;
fhir:code [
        ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
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fhir:text [ fhir:v "Intervention Group" ]       ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">932 patients opted for bariatric surgery</div>"       ] ;
      ( fhir:entry [
fhir:reference [ fhir:v "Group/172934" ] ;
fhir:type [ fhir:v "Group"^^xsd:anyURI ] ;
fhir:display [ fhir:v "InterventionGroup: JAMA 2018 Norwegian cohort study Surgery cohort" ]       ] )     ] )
  ] [
fhir:title [ fhir:v "Comparator Section" ] ;
fhir:code [
      ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
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fhir:text [ fhir:v "Comparator Description" ]       ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">medical treatment</div>"       ] ;
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fhir:reference [ fhir:v "Group/172424" ] ;
fhir:type [ fhir:v "Group"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ComparatorDefinition: NOT Bariatric Surgery (RYGB, VSG, LAGB, BPD)" ]       ] )     ] [
fhir:title [ fhir:v "Comparator Group" ] ;
fhir:code [
        ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "comparator-group" ] ;
fhir:display [ fhir:v "Comparator Group" ]         ] ) ;
fhir:text [ fhir:v "Comparator Group" ]       ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">956 opted for medical management without surgery</div>"       ] ;
      ( fhir:entry [
fhir:reference [ fhir:v "Group/172939" ] ;
fhir:type [ fhir:v "Group"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ComparatorGroup: JAMA 2018 Norwegian cohort study Control cohort" ]       ] )     ] )
  ] [
fhir:title [ fhir:v "Study Design" ] ;
fhir:code [
      ( fhir:coding [
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fhir:text [ fhir:v "Study Design" ]     ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Observational research; Parallel cohort design; Longitudinal data collection</div>"     ] ;
    ( fhir:entry [
fhir:reference [ fhir:v "ArtifactAssessment/179448" ] ;
fhir:type [ fhir:v "ArtifactAssessment"^^xsd:anyURI ] ;
fhir:display [ fhir:v "Classification: Study Design for Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort" ]     ] )
  ] [
fhir:title [ fhir:v "Baseline Measures" ] ;
fhir:code [
      ( fhir:coding [
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fhir:code [ fhir:v "baseline-measures" ] ;
fhir:display [ fhir:v "Baseline Measures" ]       ] ) ;
fhir:text [ fhir:v "Baseline Measures" ]     ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">As compared with medical patients, surgically treated patients were significantly younger with a higher BMI.</div>"     ] ;
    ( fhir:section [
fhir:title [ fhir:v "Age" ] ;
fhir:focus [
fhir:reference [ fhir:v "EvidenceVariable/179449" ] ;
fhir:type [ fhir:v "EvidenceVariable"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ExposureVariable: Age (as continuous variable)" ]       ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Mean age 41.2 in Surgical Group vs. 45.7 in Medical Group (p &lt; 0.001)</div>"       ] ;
      ( fhir:section [
fhir:title [ fhir:v "Baseline Measure with comparator alone" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-comparator-alone" ] ;
fhir:display [ fhir:v "Evidence with comparator alone" ]           ] ) ;
fhir:text [ fhir:v "Baseline Measure with comparator alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Age in Medical Group (n = 956) mean 45.7 years, SD 13.5 years</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/179451" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "BaselineMeasureEvidence: Age in 2018 Norwegian Cohort Medical Group" ]         ] )       ] [
fhir:title [ fhir:v "Baseline Measure with intervention alone" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-alone" ] ;
fhir:display [ fhir:v "Evidence with intervention alone" ]           ] ) ;
fhir:text [ fhir:v "Baseline Measure with intervention alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Age in Surgical Group (n = 932) mean 41.2 years, SD 10.5 years</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/179452" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "BaselineMeasureEvidence: Age in 2018 Norwegian Cohort Surgical Group" ]         ] )       ] [
fhir:title [ fhir:v "Baseline Measure with total group" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-total-group" ] ;
fhir:display [ fhir:v "Evidence with total group" ]           ] ) ;
fhir:text [ fhir:v "Baseline Measure with total group" ]         ] ;
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fhir:display [ fhir:v "Not Asked" ]           ] )         ]       ] [
fhir:title [ fhir:v "Baseline Measure with intervention vs. comparator" ] ;
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fhir:code [ fhir:v "evidence-with-intervention-vs-comparator" ] ;
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fhir:text [
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fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">p &lt; 0.001</div>"         ] ;
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fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ComparativeBaselineMeasureEvidence: Age in 2018 Norwegian Cohort Surgical Group vs. Medical Group" ]         ] )       ] )     ] [
fhir:title [ fhir:v "BMI" ] ;
fhir:focus [
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fhir:type [ fhir:v "EvidenceVariable"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ExposureVariable: Body Mass Index (as continuous variable)" ]       ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Mean BMI 45.4 in Surgical Group vs. 42.9 in Medical Group (p &lt; 0.001)</div>"       ] ;
      ( fhir:section [
fhir:title [ fhir:v "Baseline Measure with comparator alone" ] ;
fhir:code [
          ( fhir:coding [
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fhir:code [ fhir:v "evidence-with-comparator-alone" ] ;
fhir:display [ fhir:v "Evidence with comparator alone" ]           ] ) ;
fhir:text [ fhir:v "Baseline Measure with comparator alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">BMI in Medical Group (n = 956) mean 42.9 kg/m2, SD 5.7 kg/m2</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/179458" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "BaselineMeasureEvidence: BMI in 2018 Norwegian Cohort Medical Group" ]         ] )       ] [
fhir:title [ fhir:v "Baseline Measure with intervention alone" ] ;
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          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-alone" ] ;
fhir:display [ fhir:v "Evidence with intervention alone" ]           ] ) ;
fhir:text [ fhir:v "Baseline Measure with intervention alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">BMI in Surgical Group (n = 932) mean 45.4 kg/m2, SD 6.2 kg/m2</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/179457" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "BaselineMeasureEvidence: BMI in 2018 Norwegian Cohort Surgical Group" ]         ] )       ] [
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fhir:code [ fhir:v "evidence-with-total-group" ] ;
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fhir:text [ fhir:v "Baseline Measure with total group" ]         ] ;
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fhir:display [ fhir:v "Not Asked" ]           ] )         ]       ] [
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fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">p &lt; 0.001</div>"         ] ;
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fhir:reference [ fhir:v "Evidence/179456" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ComparativeBaselineMeasureEvidence: BMI in 2018 Norwegian Cohort Surgical Group vs. Medical Group" ]         ] )       ] )     ] )
  ] [
fhir:title [ fhir:v "Participant Flow" ] ;
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fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">2109 patients included in baseline registry, 221 patients excluded, 1888 patients included in analysis (932 had opted for bariatric surgery, 956 had opted for medical treatment)</div>"     ] ;
    ( fhir:section [
fhir:title [ fhir:v "Excluded from analysis" ] ;
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fhir:reference [ fhir:v "EvidenceVariable/179459" ] ;
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fhir:display [ fhir:v "ParticipantFlowMeasure: Exclusion from analysis" ]       ] ;
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fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">221 patients excluded from analysis</div>"       ] ;
      ( fhir:section [
fhir:title [ fhir:v "Participant flow with comparator alone" ] ;
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          ( fhir:coding [
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fhir:code [ fhir:v "evidence-with-comparator-alone" ] ;
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          ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/list-empty-reason"^^xsd:anyURI ] ;
fhir:code [ fhir:v "unavailable" ] ;
fhir:display [ fhir:v "Unavailable" ]           ] )         ]       ] [
fhir:title [ fhir:v "Participant flow with intervention alone" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-alone" ] ;
fhir:display [ fhir:v "Evidence with intervention alone" ]           ] ) ;
fhir:text [ fhir:v "Participant flow with intervention alone" ]         ] ;
fhir:emptyReason [
          ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/list-empty-reason"^^xsd:anyURI ] ;
fhir:code [ fhir:v "unavailable" ] ;
fhir:display [ fhir:v "Unavailable" ]           ] )         ]       ] [
fhir:title [ fhir:v "Participant flow with total group" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-total-group" ] ;
fhir:display [ fhir:v "Evidence with total group" ]           ] ) ;
fhir:text [ fhir:v "Participant flow with total group" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">221 excluded from analysis</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/179460" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ParticipantFlow: 2018 Norwegian Cohort Excluded from Analysis" ]         ] )       ] [
fhir:title [ fhir:v "Participant flow with intervention vs. comparator" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-vs-comparator" ] ;
fhir:display [ fhir:v "Evidence with intervention vs. comparator" ]           ] ) ;
fhir:text [ fhir:v "Participant flow with intervention vs. comparator" ]         ] ;
fhir:emptyReason [
          ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/list-empty-reason"^^xsd:anyURI ] ;
fhir:code [ fhir:v "unavailable" ] ;
fhir:display [ fhir:v "Unavailable" ]           ] )         ]       ] )     ] [
fhir:title [ fhir:v "Included in analysis" ] ;
fhir:focus [
fhir:reference [ fhir:v "EvidenceVariable/179461" ] ;
fhir:type [ fhir:v "EvidenceVariable"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ParticipantFlowMeasure: Inclusion in analysis" ]       ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">1888 patients included in analysis (932 had opted for bariatric surgery, 956 had opted for medical treatment)</div>"       ] ;
      ( fhir:section [
fhir:title [ fhir:v "Participant flow with comparator alone" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-comparator-alone" ] ;
fhir:display [ fhir:v "Evidence with comparator alone" ]           ] ) ;
fhir:text [ fhir:v "Participant flow with comparator alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">956 included in analysis</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/179464" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ParticipantFlow: 2018 Norwegian Cohort Medical Group Included in Analysis" ]         ] )       ] [
fhir:title [ fhir:v "Participant flow with intervention alone" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-alone" ] ;
fhir:display [ fhir:v "Evidence with intervention alone" ]           ] ) ;
fhir:text [ fhir:v "Participant flow with intervention alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">932 included in analysis</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/179463" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ParticipantFlow: 2018 Norwegian Cohort Surgical Group Included in Analysis" ]         ] )       ] [
fhir:title [ fhir:v "Participant flow with total group" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-total-group" ] ;
fhir:display [ fhir:v "Evidence with total group" ]           ] ) ;
fhir:text [ fhir:v "Participant flow with total group" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">1888 patients included in analysis</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/179462" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ParticipantFlow: 2018 Norwegian Cohort Included in Analysis" ]         ] )       ] [
fhir:title [ fhir:v "Participant flow with intervention vs. comparator" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-vs-comparator" ] ;
fhir:display [ fhir:v "Evidence with intervention vs. comparator" ]           ] ) ;
fhir:text [ fhir:v "Participant flow with intervention vs. comparator" ]         ] ;
fhir:emptyReason [
          ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/list-empty-reason"^^xsd:anyURI ] ;
fhir:code [ fhir:v "notasked" ] ;
fhir:display [ fhir:v "Not Asked" ]           ] )         ]       ] )     ] )
  ] [
fhir:title [ fhir:v "Outcomes" ] ;
fhir:code [
      ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "outcome-measures" ] ;
fhir:display [ fhir:v "Outcome Measures" ]       ] ) ;
fhir:text [ fhir:v "Outcomes" ]     ] ;
    ( fhir:section [
fhir:title [ fhir:v "Remission of diabetes" ] ;
fhir:focus [
fhir:reference [ fhir:v "EvidenceVariable/104117" ] ;
fhir:type [ fhir:v "EvidenceVariable"^^xsd:anyURI ] ;
fhir:display [ fhir:v "OutcomeVariable: Remission of diabetes" ]       ] ;
      ( fhir:section [
fhir:title [ fhir:v "Outcome with comparator alone" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-comparator-alone" ] ;
fhir:display [ fhir:v "Evidence with comparator alone" ]           ] ) ;
fhir:text [ fhir:v "Outcome with comparator alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Risk of Remission of diabetes in control group was 14.8%.</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/104396" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ComparatorOnlyEvidence: Remission of diabetes without bariatric surgery (Control Group) in JAMA 2018 Norwegian cohort study" ]         ] )       ] [
fhir:title [ fhir:v "Outcome with intervention alone" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-alone" ] ;
fhir:display [ fhir:v "Evidence with intervention alone" ]           ] ) ;
fhir:text [ fhir:v "Outcome with intervention alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Risk of Remission of diabetes in intervention group was 57.5%.</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/104401" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "InterventionOnlyEvidence: Remission of diabetes with bariatric surgery (Intervention Group) in JAMA 2018 Norwegian cohort study" ]         ] )       ] [
fhir:title [ fhir:v "Outcome with intervention vs. comparator" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-vs-comparator" ] ;
fhir:display [ fhir:v "Evidence with intervention vs. comparator" ]           ] ) ;
fhir:text [ fhir:v "Outcome with intervention vs. comparator" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">greater likelihood of diabetes remission: AR, 57.5% vs 14.8%; RD, 42.7% [95% CI, 35.8%-49.7%], RR, 3.9 [95% CI, 2.8-5.4]\n<br/>\nCompared with specialized medical treatment, bariatric surgery appears to induce remission of diabetes.</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/104121" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study" ]         ] )       ] )     ] [
fhir:title [ fhir:v "New onset depression" ] ;
fhir:focus [
fhir:reference [ fhir:v "EvidenceVariable/104118" ] ;
fhir:type [ fhir:v "EvidenceVariable"^^xsd:anyURI ] ;
fhir:display [ fhir:v "OutcomeVariable: New onset depression" ]       ] ;
      ( fhir:section [
fhir:title [ fhir:v "Outcome with comparator alone" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-comparator-alone" ] ;
fhir:display [ fhir:v "Evidence with comparator alone" ]           ] ) ;
fhir:text [ fhir:v "Outcome with comparator alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Risk of New onset depression in control group was 6.5%.</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/104395" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ComparatorOnlyEvidence: New onset depression without bariatric surgery (Control Group) in JAMA 2018 Norwegian cohort study" ]         ] )       ] [
fhir:title [ fhir:v "Outcome with intervention alone" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-alone" ] ;
fhir:display [ fhir:v "Evidence with intervention alone" ]           ] ) ;
fhir:text [ fhir:v "Outcome with intervention alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Risk of New onset depression in intervention group was 8.9%.</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/104400" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "InterventionOnlyEvidence: New onset depression with bariatric surgery (Intervention Group) in JAMA 2018 Norwegian cohort study" ]         ] )       ] [
fhir:title [ fhir:v "Outcome with intervention vs. comparator" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-vs-comparator" ] ;
fhir:display [ fhir:v "Evidence with intervention vs. comparator" ]           ] ) ;
fhir:text [ fhir:v "Outcome with intervention vs. comparator" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">greater risk of new-onset depression: AR, 8.9% vs 6.5%; RD, 2.4% [95% CI, 1.3%-3.5%], RR, 1.5 [95% CI, 1.4-1.7]\n<br/>\nCompared with specialized medical treatment, bariatric surgery may slightly increase the incidence of depression.</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/104155" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ComparativeEvidence: Bypass surgery effects on New onset depression in JAMA 2018 Norwegian cohort study" ]         ] )       ] )     ] [
fhir:title [ fhir:v "Treatment with opioids" ] ;
fhir:focus [
fhir:reference [ fhir:v "EvidenceVariable/104119" ] ;
fhir:type [ fhir:v "EvidenceVariable"^^xsd:anyURI ] ;
fhir:display [ fhir:v "OutcomeVariable: Treatment with opioids" ]       ] ;
      ( fhir:section [
fhir:title [ fhir:v "Outcome with comparator alone" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-comparator-alone" ] ;
fhir:display [ fhir:v "Evidence with comparator alone" ]           ] ) ;
fhir:text [ fhir:v "Outcome with comparator alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Risk of Treatment with opioids in control group was 15.8%.</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/104394" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ComparatorOnlyEvidence: Treatment with opioids without bariatric surgery (Control Group) in JAMA 2018 Norwegian cohort study" ]         ] )       ] [
fhir:title [ fhir:v "Outcome with intervention alone" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-alone" ] ;
fhir:display [ fhir:v "Evidence with intervention alone" ]           ] ) ;
fhir:text [ fhir:v "Outcome with intervention alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Risk of Treatment with opioids in intervention group was 19.4%.</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/104402" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "InterventionOnlyEvidence: Treatment with opioids with bariatric surgery (Intervention Group) in JAMA 2018 Norwegian cohort study" ]         ] )       ] [
fhir:title [ fhir:v "Outcome with intervention vs. comparator" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-vs-comparator" ] ;
fhir:display [ fhir:v "Evidence with intervention vs. comparator" ]           ] ) ;
fhir:text [ fhir:v "Outcome with intervention vs. comparator" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">greater risk of treatment with opioids: AR, 19.4% vs 15.8%, RD, 3.6% [95% CI, 2.3%-4.9%], RR, 1.3 [95% CI, 1.2-1.4]\n<br/>\nCompared with specialized medical treatment, bariatric surgery may slightly increase the use of opioids.</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/104156" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ComparativeEvidence: Bypass surgery effects on Treatment with opioids in JAMA 2018 Norwegian cohort study" ]         ] )       ] )     ] [
fhir:title [ fhir:v "Additional GI surgical procedure" ] ;
fhir:focus [
fhir:reference [ fhir:v "EvidenceVariable/104120" ] ;
fhir:type [ fhir:v "EvidenceVariable"^^xsd:anyURI ] ;
fhir:display [ fhir:v "OutcomeVariable: Additional GI surgical procedure" ]       ] ;
      ( fhir:section [
fhir:title [ fhir:v "Outcome with comparator alone" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-comparator-alone" ] ;
fhir:display [ fhir:v "Evidence with comparator alone" ]           ] ) ;
fhir:text [ fhir:v "Outcome with comparator alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Risk of additional GI surgical procedure in control group was 15.5%.</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/104385" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ComparatorOnlyEvidence: Additional GI surgical procedure without bariatric surgery (Control Group) in JAMA 2018 Norwegian cohort study" ]         ] )       ] [
fhir:title [ fhir:v "Outcome with intervention alone" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-alone" ] ;
fhir:display [ fhir:v "Evidence with intervention alone" ]           ] ) ;
fhir:text [ fhir:v "Outcome with intervention alone" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Risk of additional GI surgical procedure in intervention group was 31.3%. 292 out of 932 observed with percentage of: 31.3%</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/104398" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "InterventionOnlyEvidence: Additional GI surgical procedure with bariatric surgery (Intervention Group) in JAMA 2018 Norwegian cohort study" ]         ] )       ] [
fhir:title [ fhir:v "Outcome with intervention vs. comparator" ] ;
fhir:code [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/179423"^^xsd:anyURI ] ;
fhir:code [ fhir:v "evidence-with-intervention-vs-comparator" ] ;
fhir:display [ fhir:v "Evidence with intervention vs. comparator" ]           ] ) ;
fhir:text [ fhir:v "Outcome with intervention vs. comparator" ]         ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<div xmlns =\"http://www.w3.org/1999/xhtml\">Surgical patients had a greater risk for undergoing at least 1 additional gastrointestinal surgical procedure (AR, 31.3% vs 15.5%; RD, 15.8% [95% CI, 13.1%-18.5%]; RR, 2.0 [95% CI, 1.7-2.4]).\n<br/>\nCompared with specialized medical treatment, bariatric surgery appears to increase the rate of additional gastrointestinal surgical procedures.</div>"         ] ;
        ( fhir:entry [
fhir:reference [ fhir:v "Evidence/104157" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "ComparativeEvidence: Bypass surgery effects on Additional GI surgical procedure in JAMA 2018 Norwegian cohort study" ]         ] )       ] )     ] )
  ] ) . #