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
| Active as of 2022-09-19 |
{
"resourceType" : "Evidence",
"id" : "104121",
"meta" : {
"versionId" : "12",
"lastUpdated" : "2023-12-06T00:53:26.196Z",
"profile" : [
🔗 "http://hl7.org/fhir/uv/ebm/StructureDefinition/comparative-evidence"🔗 ,
"http://hl7.org/fhir/uv/ebm/StructureDefinition/single-study-evidence"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Evidence</b><a name=\"104121\"> </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 Evidence "104121" Version "12" Updated "2023-12-06 00:53:26+0000" </p><p style=\"margin-bottom: 0px\">Profiles: <a href=\"StructureDefinition-comparative-evidence.html\">ComparativeEvidence</a>, <a href=\"StructureDefinition-single-study-evidence.html\">SingleStudyEvidence</a></p></div><p><b>StructureDefinition Work Group</b>: cds</p><p><b>url</b>: <code>https://fevir.net/resources/Evidence/104121</code></p><p><b>identifier</b>: FEvIR Object Identifier:\u00a0104121</p><p><b>version</b>: 1.0.0-ballot</p><p><b>name</b>: ComparativeEvidence_Bypass_surgery_effects_on_Remission_of_diabetes_in_JAMA_2018_Norwegian_cohort_study</p><p><b>title</b>: ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study</p><p><b>status</b>: active</p><p><b>date</b>: 2022-09-19 21:16:23+0000</p><p><b>publisher</b>: HL7 International / Clinical Decision Support</p><p><b>contact</b>: HL7 International / Clinical Decision Support: <a href=\"http://www.hl7.org/Special/committees/dss\">http://www.hl7.org/Special/committees/dss</a></p><p><b>author</b>: Brian S. Alper: </p><h3>UseContexts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>Evidence Communication (Details: https://fevir.net/resources/CodeSystem/179423 code evidence-communication = 'Evidence Communication', stated as 'Evidence Communication')</td><td>ComparativeEvidence <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>#ComparativeEvidence)</span></td></tr><tr><td style=\"display: none\">*</td><td>Evidence Communication (Details: https://fevir.net/resources/CodeSystem/179423 code evidence-communication = 'Evidence Communication', stated as 'Evidence Communication')</td><td>SingleStudyEvidence <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>#SingleStudyEvidence)</span></td></tr></table><p><b>copyright</b>: https://creativecommons.org/licenses/by-nc-sa/4.0/</p><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: derived-from</p><blockquote><p><b>document</b></p></blockquote></blockquote><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: cite-as</p><p><b>citation</b>: ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study [Evidence]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 104121. Revised 2022-09-19. Available at: https://fevir.net/resources/Evidence/104121. Computable resource at: https://fevir.net/resources/Evidence/104121.</p></blockquote><p><b>description</b>: 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]</p><p><b>assertion</b>: Compared with specialized medical treatment, bariatric surgery appears to induce remission of diabetes.</p><blockquote><p><b>variableDefinition</b></p><p><b>VariableDefinitionVariableRoleCode</b>: population</p><p><b>description</b>: 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\u2009=\u20092109) with severe obesity assessed (221 patients excluded and 1888 patients included).</p><p><b>note</b>: population</p><p><b>variableRole</b>: Use extension:variableRoleCode instead. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-variable-role.html\">EvidenceVariableRole</a>#population "population")</span></p><p><b>observed</b>: <a href=\"Group-178427.html\">Group/178427: StudyGroup: Severely Obese Adults 2018 Norwegian Cohort</a> "Severely_Obese_Adults_2018_Norwegian_Cohort"</p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>VariableDefinitionVariableRoleCode</b>: exposure</p><p><b>VariableDefinitionComparatorCategory</b>: no bariatric surgery</p><p><b>description</b>: bariatric surgery vs. specialized medical treatment without bariatric surgery</p><p><b>note</b>: exposure</p><p><b>variableRole</b>: Use extension:variableRoleCode instead. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-variable-role.html\">EvidenceVariableRole</a>#exposure "exposure")</span></p><p><b>intended</b>: <a href=\"EvidenceVariable-172427.html\">EvidenceVariable/172427: GroupAssignment: Bariatric Surgery vs. no bariatric surgery</a> "GroupAssignment_Bariatric_Surgery_vs_no_bariatric_surgery"</p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>VariableDefinitionVariableRoleCode</b>: outcome</p><p><b>description</b>: Remission of diabetes</p><p><b>note</b>: outcome</p><p><b>variableRole</b>: Use extension:variableRoleCode instead. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-variable-role.html\">EvidenceVariableRole</a>#measuredVariable "measured variable")</span></p><p><b>observed</b>: <a href=\"EvidenceVariable-104117.html\">EvidenceVariable/104117: OutcomeVariable: Remission of diabetes</a> "OutcomeVariable_Remission_of_diabetes"</p></blockquote><p><b>synthesisType</b>: not applicable <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-synthesis-type.html\">StatisticSynthesisType</a>#NotApplicable)</span></p><p><b>studyDesign</b>: Observational research <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-study-design.html\">Study Design</a>#SEVCO:01002)</span>, Parallel cohort design <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-study-design.html\">Study Design</a>#SEVCO:01011)</span>, Longitudinal data collection <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-study-design.html\">Study Design</a>#SEVCO:01028)</span></p><blockquote><p><b>statistic</b></p><p><b>description</b>: Relative risk 3.9; 95% CI 2.8 to 5.4</p><p><b>note</b>: Result observed without bariatric surgery was 14.8%, result observed with bariatric surgery was 57.5%</p><p><b>statisticType</b>: Relative Risk <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-statistic-type.html\">StatisticStatisticType</a>#C93152)</span></p><p><b>quantity</b>: 3.9</p><h3>SampleSizes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>NumberOfStudies</b></td><td><b>NumberOfParticipants</b></td><td><b>KnownDataCount</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>1888</td><td>1888</td></tr></table><h3>AttributeEstimates</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Description</b></td><td><b>Type</b></td><td><b>Level</b></td><td><b>Range</b></td></tr><tr><td style=\"display: none\">*</td><td>95% CI 2.8 to 5.4</td><td>Confidence interval <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-attribute-estimate-type.html\">StatisticAttribute Estimate Type</a>#C53324)</span></td><td>0.95</td><td>2.8-5.4</td></tr></table></blockquote><h3>Certainties</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Description</b></td><td><b>Type</b></td><td><b>Rating</b></td></tr><tr><td style=\"display: none\">*</td><td>rated down 2 levels due to observational study, rated up 1 level due to large effect size</td><td>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></td><td>Moderate quality <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-certainty-rating.html\">StatisticCertaintyRating</a>#moderate)</span></td></tr></table></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "cds"
}
],
"url" : "https://fevir.net/resources/Evidence/104121",
"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" : "104121",
"assigner" : {
"display" : "Computable Publishing LLC"
}
}
],
"version" : "1.0.0-ballot",
"name" : "ComparativeEvidence_Bypass_surgery_effects_on_Remission_of_diabetes_in_JAMA_2018_Norwegian_cohort_study",
"title" : "ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study",
"status" : "active",
"date" : "2022-09-19T21:16:23.435Z",
"publisher" : "HL7 International / Clinical Decision Support",
"contact" : [
{
"name" : "HL7 International / Clinical Decision Support",
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/dss"
}
]
}
],
"author" : [
{
"name" : "Brian S. Alper"
}
],
"useContext" : [
{
"code" : {
"system" : "https://fevir.net/resources/CodeSystem/179423",
"code" : "evidence-communication",
"display" : "Evidence Communication"
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://fevir.net/resources/CodeSystem/179423",
"code" : "ComparativeEvidence",
"display" : "ComparativeEvidence"
}
]
}
},
{
"code" : {
"system" : "https://fevir.net/resources/CodeSystem/179423",
"code" : "evidence-communication",
"display" : "Evidence Communication"
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://fevir.net/resources/CodeSystem/179423",
"code" : "SingleStudyEvidence",
"display" : "SingleStudyEvidence"
}
]
}
}
],
"copyright" : "https://creativecommons.org/licenses/by-nc-sa/4.0/",
"relatedArtifact" : [
{
"type" : "derived-from",
"document" : {
"url" : "https://jamanetwork.com/journals/jama/fullarticle/2669729"
}
},
{
"type" : "cite-as",
"citation" : "ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study [Evidence]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 104121. Revised 2022-09-19. Available at: https://fevir.net/resources/Evidence/104121. Computable resource at: https://fevir.net/resources/Evidence/104121."
}
],
"description" : "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]",
"assertion" : "Compared with specialized medical treatment, bariatric surgery appears to induce remission of diabetes.",
"variableDefinition" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code",
"valueCode" : "population"
}
],
"description" : "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\u2009=\u20092109) with severe obesity assessed (221 patients excluded and 1888 patients included).",
"note" : [
{
"text" : "population"
}
],
"variableRole" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/variable-role",
"code" : "population",
"display" : "population"
}
],
"text" : "Use extension:variableRoleCode instead."
},
"observed" : {
🔗 "reference" : "Group/178427",
"type" : "Group",
"display" : "StudyGroup: Severely Obese Adults 2018 Norwegian Cohort"
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code",
"valueCode" : "exposure"
},
{
"url" : "http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-comparator-category",
"valueString" : "no bariatric surgery"
}
],
"description" : "bariatric surgery vs. specialized medical treatment without bariatric surgery",
"note" : [
{
"text" : "exposure"
}
],
"variableRole" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/variable-role",
"code" : "exposure",
"display" : "exposure"
}
],
"text" : "Use extension:variableRoleCode instead."
},
"intended" : {
🔗 "reference" : "EvidenceVariable/172427",
"type" : "EvidenceVariable",
"display" : "GroupAssignment: Bariatric Surgery vs. no bariatric surgery"
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code",
"valueCode" : "outcome"
}
],
"description" : "Remission of diabetes",
"note" : [
{
"text" : "outcome"
}
],
"variableRole" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/variable-role",
"code" : "measuredVariable",
"display" : "measured variable"
}
],
"text" : "Use extension:variableRoleCode instead."
},
"observed" : {
🔗 "reference" : "EvidenceVariable/104117",
"type" : "EvidenceVariable",
"display" : "OutcomeVariable: Remission of diabetes"
}
}
],
"synthesisType" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/synthesis-type",
"code" : "NotApplicable",
"display" : "not applicable"
}
]
},
"studyDesign" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/study-design",
"code" : "SEVCO:01002",
"display" : "Observational research"
}
]
},
{
"coding" : [
{
"system" : "http://hl7.org/fhir/study-design",
"code" : "SEVCO:01011",
"display" : "Parallel cohort design"
}
]
},
{
"coding" : [
{
"system" : "http://hl7.org/fhir/study-design",
"code" : "SEVCO:01028",
"display" : "Longitudinal data collection"
}
]
}
],
"statistic" : [
{
"description" : "Relative risk 3.9; 95% CI 2.8 to 5.4",
"note" : [
{
"text" : "Result observed without bariatric surgery was 14.8%, result observed with bariatric surgery was 57.5%"
}
],
"statisticType" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/statistic-type",
"code" : "C93152",
"display" : "Relative Risk"
}
]
},
"quantity" : {
"value" : 3.9
},
"sampleSize" : {
"numberOfStudies" : 1,
"numberOfParticipants" : 1888,
"knownDataCount" : 1888
},
"attributeEstimate" : [
{
"description" : "95% CI 2.8 to 5.4",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/attribute-estimate-type",
"code" : "C53324",
"display" : "Confidence interval"
}
]
},
"level" : 0.95,
"range" : {
"low" : {
"value" : 2.8
},
"high" : {
"value" : 5.4
}
}
}
]
}
],
"certainty" : [
{
"description" : "rated down 2 levels due to observational study, rated up 1 level due to large effect size",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-type",
"code" : "Overall",
"display" : "Overall certainty"
}
]
},
"rating" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/certainty-rating",
"code" : "moderate",
"display" : "Moderate quality"
}
]
}
}
]
}
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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