ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study - 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
: ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study - TTL Representation

Active as of 2022-09-19
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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 -------------------------------------------------------------------

 a fhir:Evidence ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "104121"] ; # 
  fhir:meta [
fhir:versionId [ fhir:v "12" ] ;
fhir:lastUpdated [ fhir:v "2023-12-06T00:53:26.196Z"^^xsd:dateTime ] ;
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/uv/ebm/StructureDefinition/comparative-evidence"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/uv/ebm/StructureDefinition/comparative-evidence>     ] [
fhir:v "http://hl7.org/fhir/uv/ebm/StructureDefinition/single-study-evidence"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/uv/ebm/StructureDefinition/single-study-evidence>     ] )
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fhir: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 &quot;104121&quot; Version &quot;12&quot; Updated &quot;2023-12-06 00:53:26+0000&quot; </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: 104121</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 = 2109) 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 &quot;population&quot;)</span></p><p><b>observed</b>: <a href=\"Group-178427.html\">Group/178427: StudyGroup: Severely Obese Adults 2018 Norwegian Cohort</a> &quot;Severely_Obese_Adults_2018_Norwegian_Cohort&quot;</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 &quot;exposure&quot;)</span></p><p><b>intended</b>: <a href=\"EvidenceVariable-172427.html\">EvidenceVariable/172427: GroupAssignment: Bariatric Surgery vs. no bariatric surgery</a> &quot;GroupAssignment_Bariatric_Surgery_vs_no_bariatric_surgery&quot;</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 &quot;measured variable&quot;)</span></p><p><b>observed</b>: <a href=\"EvidenceVariable-104117.html\">EvidenceVariable/104117: OutcomeVariable: Remission of diabetes</a> &quot;OutcomeVariable_Remission_of_diabetes&quot;</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>"
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  fhir:name [ fhir:v "ComparativeEvidence_Bypass_surgery_effects_on_Remission_of_diabetes_in_JAMA_2018_Norwegian_cohort_study"] ; # 
  fhir:title [ fhir:v "ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:date [ fhir:v "2022-09-19T21:16:23.435Z"^^xsd:dateTime] ; # 
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fhir:type [ fhir:v "derived-from" ] ;
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fhir:url [ fhir:v "https://jamanetwork.com/journals/jama/fullarticle/2669729"^^xsd:anyURI ]     ]
  ] [
fhir:type [ fhir:v "cite-as" ] ;
fhir:citation [ fhir:v "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." ]
  ] ) ; # 
  fhir:description [ fhir:v "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]"] ; # 
  fhir:assertion [ fhir:v "Compared with specialized medical treatment, bariatric surgery appears to induce remission of diabetes."] ; # 
  fhir:variableDefinition ( [
    ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code"^^xsd:anyURI ] ;
fhir:value [ fhir:v "population" ]     ] ) ;
fhir:description [ fhir:v "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)." ] ;
    ( fhir:note [
fhir:text [ fhir:v "population" ]     ] ) ;
fhir:variableRole [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/variable-role"^^xsd:anyURI ] ;
fhir:code [ fhir:v "population" ] ;
fhir:display [ fhir:v "population" ]       ] ) ;
fhir:text [ fhir:v "Use extension:variableRoleCode instead." ]     ] ;
fhir:observed [
fhir:reference [ fhir:v "Group/178427" ] ;
fhir:type [ fhir:v "Group"^^xsd:anyURI ] ;
fhir:display [ fhir:v "StudyGroup: Severely Obese Adults 2018 Norwegian Cohort" ]     ]
  ] [
    ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code"^^xsd:anyURI ] ;
fhir:value [ fhir:v "exposure" ]     ] [
fhir:url [ fhir:v "http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-comparator-category"^^xsd:anyURI ] ;
fhir:value [ fhir:v "no bariatric surgery" ]     ] ) ;
fhir:description [ fhir:v "bariatric surgery vs. specialized medical treatment without bariatric surgery" ] ;
    ( fhir:note [
fhir:text [ fhir:v "exposure" ]     ] ) ;
fhir:variableRole [
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fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/variable-role"^^xsd:anyURI ] ;
fhir:code [ fhir:v "exposure" ] ;
fhir:display [ fhir:v "exposure" ]       ] ) ;
fhir:text [ fhir:v "Use extension:variableRoleCode instead." ]     ] ;
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fhir:reference [ fhir:v "EvidenceVariable/172427" ] ;
fhir:type [ fhir:v "EvidenceVariable"^^xsd:anyURI ] ;
fhir:display [ fhir:v "GroupAssignment: Bariatric Surgery vs. no bariatric surgery" ]     ]
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    ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code"^^xsd:anyURI ] ;
fhir:value [ fhir:v "outcome" ]     ] ) ;
fhir:description [ fhir:v "Remission of diabetes" ] ;
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fhir:text [ fhir:v "outcome" ]     ] ) ;
fhir:variableRole [
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fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/variable-role"^^xsd:anyURI ] ;
fhir:code [ fhir:v "measuredVariable" ] ;
fhir:display [ fhir:v "measured variable" ]       ] ) ;
fhir:text [ fhir:v "Use extension:variableRoleCode instead." ]     ] ;
fhir:observed [
fhir:reference [ fhir:v "EvidenceVariable/104117" ] ;
fhir:type [ fhir:v "EvidenceVariable"^^xsd:anyURI ] ;
fhir:display [ fhir:v "OutcomeVariable: Remission of diabetes" ]     ]
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  fhir:synthesisType [
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fhir:code [ fhir:v "NotApplicable" ] ;
fhir:display [ fhir:v "not applicable" ]     ] )
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  fhir:studyDesign ( [
    ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/study-design"^^xsd:anyURI ] ;
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fhir:system [ fhir:v "http://hl7.org/fhir/study-design"^^xsd:anyURI ] ;
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fhir:code [ fhir:v "SEVCO:01028" ] ;
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fhir:description [ fhir:v "Relative risk 3.9; 95% CI 2.8 to 5.4" ] ;
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fhir:text [ fhir:v "Result observed without bariatric surgery was 14.8%, result observed with bariatric surgery was 57.5%" ]     ] ) ;
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fhir:value [ fhir:v "3.9"^^xsd:decimal ]     ] ;
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fhir:numberOfStudies [ fhir:v "1"^^xsd:nonNegativeInteger ] ;
fhir:numberOfParticipants [ fhir:v "1888"^^xsd:nonNegativeInteger ] ;
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fhir:description [ fhir:v "95% CI 2.8 to 5.4" ] ;
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fhir:description [ fhir:v "rated down 2 levels due to observational study, rated up 1 level due to large effect size" ] ;
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fhir:system [ fhir:v "http://hl7.org/fhir/certainty-type"^^xsd:anyURI ] ;
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fhir:code [ fhir:v "moderate" ] ;
fhir:display [ fhir:v "Moderate quality" ]       ] )     ]
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