Generated Narrative: Evidence

StructureDefinition Work Group: cds

url: https://fevir.net/resources/Evidence/104098

identifier: FEvIR Object Identifier: 104098

version: 1.0.0-ballot

name: ComparativeEvidence_Bypass_surgery_effects_on_Myocardial_infarction_or_stroke_in_Swedish_Obese_Subjects_SOS_study

title: ComparativeEvidence: Bypass surgery effects on Myocardial infarction or stroke in Swedish Obese Subjects (SOS) study

status: active

date: 2022-09-19 21:15:57+0000

publisher: HL7 International / Clinical Decision Support

contact: HL7 International / Clinical Decision Support: http://www.hl7.org/Special/committees/dss

author: Brian S. Alper:

copyright: https://creativecommons.org/licenses/by-nc-sa/4.0/

relatedArtifact

type: derived-from

document

relatedArtifact

type: cite-as

citation: ComparativeEvidence: Bypass surgery effects on Myocardial infarction or stroke in Swedish Obese Subjects (SOS) study [Evidence]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 104098. Revised 2022-09-19. Available at: https://fevir.net/resources/Evidence/104098. Computable resource at: https://fevir.net/resources/Evidence/104098.

description: Bariatric surgery was associated with a reduced number of cardiovascular deaths (28 events among 2010 patients in the surgery group vs 49 events among 2037 patients in the control group; adjusted hazard ratio [HR], 0.47; 95% CI, 0.29-0.76; P = .002). The number of total first time (fatal or nonfatal) cardiovascular events (myocardial infarction or stroke, whichever came first) was lower in the surgery group (199 events among 2010 patients) than in the control group (234 events among 2037 patients; adjusted HR, 0.67; 95% CI, 0.54-0.83; P < .001). -- Extrapolated from this data the outcome of Nonfatal myocardial infarction or stroke occurred in 188 out of 2037 patients in the control group and 171 out of 2010 patients in the surgery group, and the adjusted HR for total events is assumed to apply (adjusted HR 0.67, 95% CI 0.54 to 0.83)

assertion: Compared with usual care, bariatric surgery was associated with reduced number of cardiovascular deaths and lower incidence of cardiovascular events in obese adults.

variableDefinition

VariableDefinitionVariableRoleCode: population

description: Inclusion criteria were age 37 to 60 years and a body mass index of at least 34 in men and at least 38 in women. All in Sweden.

note: population

variableRole: Use extension:variableRoleCode instead. (EvidenceVariableRole#population "population")

variableDefinition

VariableDefinitionVariableRoleCode: exposure

VariableDefinitionComparatorCategory: no bariatric surgery

description: bariatric surgery vs. usual care without bariatric surgery

note: exposure

variableRole: Use extension:variableRoleCode instead. (EvidenceVariableRole#exposure "exposure")

intended: EvidenceVariable/172427: GroupAssignment: Bariatric Surgery vs. no bariatric surgery "GroupAssignment_Bariatric_Surgery_vs_no_bariatric_surgery"

variableDefinition

VariableDefinitionVariableRoleCode: outcome

description: nonfatal myocardial infarction or stroke

note: outcome

variableRole: Use extension:variableRoleCode instead. (EvidenceVariableRole#measuredVariable "measured variable")

observed: EvidenceVariable/104097: OutcomeVariable: Nonfatal myocardial infarction or stroke "OutcomeVariable_Nonfatal_myocardial_infarction_or_stroke"

synthesisType: not applicable (StatisticSynthesisType#NotApplicable)

studyDesign: Observational research (Study Design#SEVCO:01002), Parallel cohort design (Study Design#SEVCO:01011), Matching for comparison (Study Design#SEVCO:01014), Longitudinal data collection (Study Design#SEVCO:01028)

statistic

description: Hazard ratio, adjusted 0.67; 95% CI 0.54 to 0.83

note: The event rates are calculated from the reported total (fatal and nonfatal events) minus the fatal events. Nonfatal myocardial infarction or stroke occurred in 188 out of 2037 patients in the control group and 171 out of 2010 patients in the surgery group, and the adjusted HR for total events is assumed to apply (adjusted HR 0.67, 95% CI 0.54 to 0.83)

statisticType: Hazard Ratio (StatisticStatisticType#C93150)

quantity: 0.67

numberAffected: 359

SampleSizes

-	NumberOfParticipants	KnownDataCount
*	4047	4047

AttributeEstimates

-	Description	Type	Level	Range
*	95% CI 0.54 to 0.83	Confidence interval (StatisticAttribute Estimate Type#C53324)	0.95	0.54-0.83

ModelCharacteristics

-	Code
*	Adjusted analysis (Scientific Evidence Code System (SEVCO) -- EXAMPLE VERSION for EBMonFHIR Implementation Guide#TBD:0000120 "Adjustment for covariates")

Certainties