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 |
<Evidence xmlns="http://hl7.org/fhir">
<id value="104121"/>
<meta>
<versionId value="12"/>
<lastUpdated value="2023-12-06T00:53:26.196Z"/>
<profile
value="http://hl7.org/fhir/uv/ebm/StructureDefinition/comparative-evidence"/>
<profile
value="http://hl7.org/fhir/uv/ebm/StructureDefinition/single-study-evidence"/>
</meta>
<text>
<status value="extensions"/>
<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: 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 "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>
</text>
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<url value="https://fevir.net/resources/Evidence/104121"/>
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<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="ACSN"/>
<display value="Accession ID"/>
</coding>
<text value="FEvIR Object Identifier"/>
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<system value="https://fevir.net"/>
<value value="104121"/>
<assigner>
<display value="Computable Publishing LLC"/>
</assigner>
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<version value="1.0.0-ballot"/>
<name
value="ComparativeEvidence_Bypass_surgery_effects_on_Remission_of_diabetes_in_JAMA_2018_Norwegian_cohort_study"/>
<title
value="ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study"/>
<status value="active"/>
<date value="2022-09-19T21:16:23.435Z"/>
<publisher value="HL7 International / Clinical Decision Support"/>
<contact>
<name value="HL7 International / Clinical Decision Support"/>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/dss"/>
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<author>
<name value="Brian S. Alper"/>
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<useContext>
<code>
<system value="https://fevir.net/resources/CodeSystem/179423"/>
<code value="evidence-communication"/>
<display value="Evidence Communication"/>
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<coding>
<system value="https://fevir.net/resources/CodeSystem/179423"/>
<code value="ComparativeEvidence"/>
<display value="ComparativeEvidence"/>
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<useContext>
<code>
<system value="https://fevir.net/resources/CodeSystem/179423"/>
<code value="evidence-communication"/>
<display value="Evidence Communication"/>
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<valueCodeableConcept>
<coding>
<system value="https://fevir.net/resources/CodeSystem/179423"/>
<code value="SingleStudyEvidence"/>
<display value="SingleStudyEvidence"/>
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<copyright value="https://creativecommons.org/licenses/by-nc-sa/4.0/"/>
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<type value="derived-from"/>
<document>
<url value="https://jamanetwork.com/journals/jama/fullarticle/2669729"/>
</document>
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<relatedArtifact>
<type value="cite-as"/>
<citation
value="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."/>
</relatedArtifact>
<description
value="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
value="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 value="population"/>
</extension>
<description
value="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)."/>
<note>
<text value="population"/>
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<variableRole>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/variable-role"/>
<code value="population"/>
<display value="population"/>
</coding>
<text value="Use extension:variableRoleCode instead."/>
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<observed>🔗
<reference value="Group/178427"/>
<type value="Group"/>
<display
value="StudyGroup: Severely Obese Adults 2018 Norwegian Cohort"/>
</observed>
</variableDefinition>
<variableDefinition>
<extension
url="http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code">
<valueCode value="exposure"/>
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<extension
url="http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-comparator-category">
<valueString value="no bariatric surgery"/>
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<description
value="bariatric surgery vs. specialized medical treatment without bariatric surgery"/>
<note>
<text value="exposure"/>
</note>
<variableRole>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/variable-role"/>
<code value="exposure"/>
<display value="exposure"/>
</coding>
<text value="Use extension:variableRoleCode instead."/>
</variableRole>
<intended>🔗
<reference value="EvidenceVariable/172427"/>
<type value="EvidenceVariable"/>
<display
value="GroupAssignment: Bariatric Surgery vs. no bariatric surgery"/>
</intended>
</variableDefinition>
<variableDefinition>
<extension
url="http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code">
<valueCode value="outcome"/>
</extension>
<description value="Remission of diabetes"/>
<note>
<text value="outcome"/>
</note>
<variableRole>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/variable-role"/>
<code value="measuredVariable"/>
<display value="measured variable"/>
</coding>
<text value="Use extension:variableRoleCode instead."/>
</variableRole>
<observed>🔗
<reference value="EvidenceVariable/104117"/>
<type value="EvidenceVariable"/>
<display value="OutcomeVariable: Remission of diabetes"/>
</observed>
</variableDefinition>
<synthesisType>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/synthesis-type"/>
<code value="NotApplicable"/>
<display value="not applicable"/>
</coding>
</synthesisType>
<studyDesign>
<coding>
<system value="http://hl7.org/fhir/study-design"/>
<code value="SEVCO:01002"/>
<display value="Observational research"/>
</coding>
</studyDesign>
<studyDesign>
<coding>
<system value="http://hl7.org/fhir/study-design"/>
<code value="SEVCO:01011"/>
<display value="Parallel cohort design"/>
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</studyDesign>
<studyDesign>
<coding>
<system value="http://hl7.org/fhir/study-design"/>
<code value="SEVCO:01028"/>
<display value="Longitudinal data collection"/>
</coding>
</studyDesign>
<statistic>
<description value="Relative risk 3.9; 95% CI 2.8 to 5.4"/>
<note>
<text
value="Result observed without bariatric surgery was 14.8%, result observed with bariatric surgery was 57.5%"/>
</note>
<statisticType>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/statistic-type"/>
<code value="C93152"/>
<display value="Relative Risk"/>
</coding>
</statisticType>
<quantity>
<value value="3.9"/>
</quantity>
<sampleSize>
<numberOfStudies value="1"/>
<numberOfParticipants value="1888"/>
<knownDataCount value="1888"/>
</sampleSize>
<attributeEstimate>
<description value="95% CI 2.8 to 5.4"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/attribute-estimate-type"/>
<code value="C53324"/>
<display value="Confidence interval"/>
</coding>
</type>
<level value="0.95"/>
<range>
<low>
<value value="2.8"/>
</low>
<high>
<value value="5.4"/>
</high>
</range>
</attributeEstimate>
</statistic>
<certainty>
<description
value="rated down 2 levels due to observational study, rated up 1 level due to large effect size"/>
<type>
<coding>
<system value="http://hl7.org/fhir/certainty-type"/>
<code value="Overall"/>
<display value="Overall certainty"/>
</coding>
</type>
<rating>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
<code value="moderate"/>
<display value="Moderate quality"/>
</coding>
</rating>
</certainty>
</Evidence>
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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