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="104157"/>
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<lastUpdated value="2023-12-06T00:52:08.440Z"/>
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<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Evidence</b><a name="104157"> </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 "104157" Version "12" Updated "2023-12-06 00:52:08+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/104157</code></p><p><b>identifier</b>: FEvIR Object Identifier: 104157</p><p><b>version</b>: 1.0.0-ballot</p><p><b>name</b>: ComparativeEvidence_Bypass_surgery_effects_on_Additional_GI_surgical_procedure_in_JAMA_2018_Norwegian_cohort_study</p><p><b>title</b>: ComparativeEvidence: Bypass surgery effects on Additional GI surgical procedure in JAMA 2018 Norwegian cohort study</p><p><b>status</b>: active</p><p><b>date</b>: 2022-09-19 21:15:43+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 Additional GI surgical procedure in JAMA 2018 Norwegian cohort study [Evidence]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 104157. Revised 2022-09-19. Available at: https://fevir.net/resources/Evidence/104157. Computable resource at: https://fevir.net/resources/Evidence/104157.</p></blockquote><p><b>description</b>: 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]).</p><p><b>assertion</b>: Compared with specialized medical treatment, bariatric surgery appears to increase the rate of additional gastrointestinal surgical procedures.</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>observed</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>: Additional GI surgical procedure</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-104120.html">EvidenceVariable/104120: OutcomeVariable: Additional GI surgical procedure</a> "OutcomeVariable_Additional_GI_surgical_procedure"</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 2.0; 95% CI 1.7 to 2.4</p><p><b>note</b>: Result observed without bariatric surgery was 15.5%, result observed with bariatric surgery was 31.3%</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>: 2</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 1.7 to 2.4</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>1.7-2.4</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 for 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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<title
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<date value="2022-09-19T21:15:43.661Z"/>
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<citation
value="ComparativeEvidence: Bypass surgery effects on Additional GI surgical procedure in JAMA 2018 Norwegian cohort study [Evidence]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 104157. Revised 2022-09-19. Available at: https://fevir.net/resources/Evidence/104157. Computable resource at: https://fevir.net/resources/Evidence/104157."/>
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<description
value="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])."/>
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value="Compared with specialized medical treatment, bariatric surgery appears to increase the rate of additional gastrointestinal surgical procedures."/>
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url="http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code">
<valueCode value="population"/>
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<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)."/>
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<coding>
<system value="http://terminology.hl7.org/CodeSystem/variable-role"/>
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<display value="population"/>
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<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"/>
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<variableDefinition>
<extension
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<description
value="bariatric surgery vs. specialized medical treatment without bariatric surgery"/>
<note>
<text value="exposure"/>
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<variableRole>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/variable-role"/>
<code value="exposure"/>
<display value="exposure"/>
</coding>
<text value="Use extension:variableRoleCode instead."/>
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<observed>🔗
<reference value="EvidenceVariable/172427"/>
<type value="EvidenceVariable"/>
<display
value="GroupAssignment: Bariatric Surgery vs. no bariatric surgery"/>
</observed>
</variableDefinition>
<variableDefinition>
<extension
url="http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code">
<valueCode value="outcome"/>
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<description value="Additional GI surgical procedure"/>
<note>
<text value="outcome"/>
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<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."/>
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<observed>🔗
<reference value="EvidenceVariable/104120"/>
<type value="EvidenceVariable"/>
<display value="OutcomeVariable: Additional GI surgical procedure"/>
</observed>
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<synthesisType>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/synthesis-type"/>
<code value="NotApplicable"/>
<display value="not applicable"/>
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<studyDesign>
<coding>
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<code value="SEVCO:01002"/>
<display value="Observational research"/>
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<studyDesign>
<coding>
<system value="http://hl7.org/fhir/study-design"/>
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<studyDesign>
<coding>
<system value="http://hl7.org/fhir/study-design"/>
<code value="SEVCO:01028"/>
<display value="Longitudinal data collection"/>
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<statistic>
<description value="Relative risk 2.0; 95% CI 1.7 to 2.4"/>
<note>
<text
value="Result observed without bariatric surgery was 15.5%, result observed with bariatric surgery was 31.3%"/>
</note>
<statisticType>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/statistic-type"/>
<code value="C93152"/>
<display value="Relative Risk"/>
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<quantity>
<value value="2"/>
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<sampleSize>
<numberOfStudies value="1"/>
<numberOfParticipants value="1888"/>
<knownDataCount value="1888"/>
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<attributeEstimate>
<description value="95% CI 1.7 to 2.4"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/attribute-estimate-type"/>
<code value="C53324"/>
<display value="Confidence interval"/>
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<level value="0.95"/>
<range>
<low>
<value value="1.7"/>
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<high>
<value value="2.4"/>
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</statistic>
<certainty>
<description
value="rated down 2 levels due to observational study, rated up 1 level for large effect size"/>
<type>
<coding>
<system value="http://hl7.org/fhir/certainty-type"/>
<code value="Overall"/>
<display value="Overall certainty"/>
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<rating>
<coding>
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value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
<code value="moderate"/>
<display value="Moderate quality"/>
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</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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