Release 5 Preview #1

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Evidence-example-mortalitylongterm-nocorticosteroids.ttl

Clinical Decision Support Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Not linked to any defined compartments

Raw Turtle (+ also see Turtle/RDF Format Specification)

No corticosteroids for Patients with Sepsis with Mortality (60 days to 1 year)

@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 -------------------------------------------------------------------

<http://hl7.org/fhir/Evidence/Evidence-Example-MortalityLongTerm-NoCorticosteroids> a fhir:Evidence;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "Evidence-Example-MortalityLongTerm-NoCorticosteroids"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: Evidence-Example-MortalityLongTerm-NoCorticosteroids</p><p><b>title</b>: No corticosteroids for Patients with Sepsis with Mortality (60 days to 1 year)</p><p><b>status</b>: draft</p><p><b>relatedArtifact</b>: </p><p><b>description</b>: Occurrence of Mortality with No corticosteroids for patients with sepsis</p><h3>ReferentGroups</h3><table><tr><td>-</td><td><b>Description</b></td><td><b>EvidenceSource</b></td><td><b>IntendedGroup</b></td><td><b>DirectnessMatch</b></td></tr><tr><td>*</td><td>Patients with sepsis</td><td>???</td><td>Patients with sepsis</td><td>??? <span>(Details : {http://terminology.hl7.org/CodeSystem/directness code 'null' = 'null', given as '???'})</span></td></tr></table><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: Mortality Longer term (60 days to 1 year)</p><p><b>variableRole</b>: measured variable <span>(Details : {http://terminology.hl7.org/CodeSystem/variable-role code 'measuredVariable' = 'measured variable', given as 'measured variable'})</span></p><p><b>actualDefinition</b>: many studies had shorter term outcomes</p><p><b>intendedDefinition</b>: Mortality Longer term (Follow up: 60 days to 1 year)</p><p><b>directnessMatch</b>: moderate <span>(Details : {http://terminology.hl7.org/CodeSystem/directness code 'moderate' = 'Moderate quality match', given as 'moderate'})</span></p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: No corticosteroids</p><p><b>variableRole</b>: referenceExposure <span>(Details : {http://terminology.hl7.org/CodeSystem/variable-role code 'referenceExposure' = 'reference exposure', given as 'referenceExposure'})</span></p><p><b>actualDefinition</b>: ???</p><p><b>intendedDefinition</b>: No corticosteroids</p><p><b>directnessMatch</b>: ??? <span>(Details : {http://terminology.hl7.org/CodeSystem/directness code 'null' = 'null', given as '???'})</span></p></blockquote><p><b>synthesisType</b>: summary data meta-analysis <span>(Details : {http://terminology.hl7.org/CodeSystem/synthesis-type code 'std-MA' = 'summary data meta-analysis', given as 'summary data meta-analysis'})</span></p><p><b>studyType</b>: randomized trial <span>(Details : {http://terminology.hl7.org/CodeSystem/study-type code 'RCT' = 'randomized trial', given as 'randomized trial'})</span></p><p><b>statistic</b>: </p><blockquote><p><b>certainty</b></p><p><b>description</b>: Low, due to serious imprecision and indirectness.</p><p><b>rating</b>: Low quality <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-rating code 'low' = 'Low quality', given as 'Low quality'})</span></p><blockquote><p><b>certaintySubcomponent</b></p><p><b>note</b>: Note that all studies that reported 90 day to 1 year mortality also reported 28-30 day mortality: the CI 95% around the pooled effect for short term mortality also excludes no effect: RR 0.91 (CI 95% 0.84 - 0.98).</p><p><b>type</b>: Risk of bias <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type code 'RiskOfBias' = 'Risk of bias', given as 'Risk of bias'})</span></p><p><b>rating</b>: no serious concern <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating code 'no-concern' = 'no serious concern', given as 'no serious concern'})</span></p></blockquote><blockquote><p><b>certaintySubcomponent</b></p><p><b>type</b>: Inconsistency <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type code 'Inconsistency' = 'Inconsistency', given as 'Inconsistency'})</span></p><p><b>rating</b>: no serious concern <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating code 'no-concern' = 'no serious concern', given as 'no serious concern'})</span></p></blockquote><blockquote><p><b>certaintySubcomponent</b></p><p><b>note</b>: Only a small proportion of studies reported longer-term mortality.</p><p><b>type</b>: Indirectness <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type code 'Indirectness' = 'Indirectness', given as 'Indirectness'})</span></p><p><b>rating</b>: serious concern <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating code 'serious-concern' = 'serious concern', given as 'serious concern'})</span></p></blockquote><blockquote><p><b>certaintySubcomponent</b></p><p><b>note</b>: Confidence interval includes no effect.</p><p><b>type</b>: Imprecision <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type code 'Imprecision' = 'Imprecision', given as 'Imprecision'})</span></p><p><b>rating</b>: serious concern <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating code 'serious-concern' = 'serious concern', given as 'serious concern'})</span></p></blockquote><blockquote><p><b>certaintySubcomponent</b></p><p><b>type</b>: Publication bias <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type code 'PublicationBias' = 'Publication bias', given as 'Publication bias'})</span></p><p><b>rating</b>: no serious concern <span>(Details : {http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating code 'no-concern' = 'no serious concern', given as 'no serious concern'})</span></p></blockquote></blockquote></div>"
  ];
  fhir:Evidence.title [ fhir:value "No corticosteroids for Patients with Sepsis with Mortality (60 days to 1 year)"];
  fhir:Evidence.status [ fhir:value "draft"];
  fhir:Evidence.relatedArtifact [
     fhir:index 0;
     fhir:RelatedArtifact.type [ fhir:value "derived-from" ];
     fhir:RelatedArtifact.url [ fhir:value "https://app.magicapp.org/public/guideline/EZ1w8n/pico/31831/widget?tab=outcome" ]
  ];
  fhir:Evidence.description [ fhir:value "Occurrence of Mortality with No corticosteroids for patients with sepsis"];
  fhir:Evidence.referentGroup [
     fhir:Evidence.referentGroup.description [ fhir:value "Patients with sepsis" ];
     fhir:Evidence.referentGroup.evidenceSource [
       fhir:Reference.type [ fhir:value "Group" ];
       fhir:Reference.display [ fhir:value "???" ]
     ];
     fhir:Evidence.referentGroup.intendedGroup [
       fhir:Reference.type [ fhir:value "Group" ];
       fhir:Reference.display [ fhir:value "Patients with sepsis" ]
     ];
     fhir:Evidence.referentGroup.directnessMatch [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/directness" ];
         fhir:Coding.display [ fhir:value "???" ]
       ]
     ]
  ];
  fhir:Evidence.variableDefinition [
     fhir:index 0;
     fhir:Evidence.variableDefinition.description [ fhir:value "Mortality Longer term (60 days to 1 year)" ];
     fhir:Evidence.variableDefinition.variableRole [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/variable-role" ];
         fhir:Coding.code [ fhir:value "measuredVariable" ];
         fhir:Coding.display [ fhir:value "measured variable" ]
       ]
     ];
     fhir:Evidence.variableDefinition.actualDefinition [
       fhir:Reference.type [ fhir:value "EvidenceVariable" ];
       fhir:Reference.display [ fhir:value "many studies had shorter term outcomes" ]
     ];
     fhir:Evidence.variableDefinition.intendedDefinition [
       fhir:Reference.type [ fhir:value "EvidenceVariable" ];
       fhir:Reference.display [ fhir:value "Mortality Longer term (Follow up: 60 days to 1 year)" ]
     ];
     fhir:Evidence.variableDefinition.directnessMatch [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/directness" ];
         fhir:Coding.code [ fhir:value "moderate" ];
         fhir:Coding.display [ fhir:value "moderate" ]
       ]
     ]
  ], [
     fhir:index 1;
     fhir:Evidence.variableDefinition.description [ fhir:value "No corticosteroids" ];
     fhir:Evidence.variableDefinition.variableRole [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/variable-role" ];
         fhir:Coding.code [ fhir:value "referenceExposure" ];
         fhir:Coding.display [ fhir:value "referenceExposure" ]
       ]
     ];
     fhir:Evidence.variableDefinition.actualDefinition [
       fhir:Reference.type [ fhir:value "EvidenceVariable" ];
       fhir:Reference.display [ fhir:value "???" ]
     ];
     fhir:Evidence.variableDefinition.intendedDefinition [
       fhir:Reference.type [ fhir:value "EvidenceVariable" ];
       fhir:Reference.display [ fhir:value "No corticosteroids" ]
     ];
     fhir:Evidence.variableDefinition.directnessMatch [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/directness" ];
         fhir:Coding.display [ fhir:value "???" ]
       ]
     ]
  ];
  fhir:Evidence.synthesisType [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/synthesis-type" ];
       fhir:Coding.code [ fhir:value "std-MA" ];
       fhir:Coding.display [ fhir:value "summary data meta-analysis" ]
     ]
  ];
  fhir:Evidence.studyType [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/study-type" ];
       fhir:Coding.code [ fhir:value "RCT" ];
       fhir:Coding.display [ fhir:value "randomized trial" ]
     ]
  ];
  fhir:Evidence.statistic [
     fhir:index 0;
     fhir:Statistic.description [ fhir:value "371 per 1000" ];
     fhir:Statistic.note [
       fhir:index 0;
       fhir:Annotation.text [ fhir:value "371 per 1000 experienced Mortality (60 days to 1 year)" ]
     ];
     fhir:Statistic.statisticType [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/statistic-type" ];
         fhir:Coding.code [ fhir:value "C44256" ];
         fhir:Coding.display [ fhir:value "proportion" ]
       ]
     ];
     fhir:Statistic.quantity [
       fhir:Quantity.value [ fhir:value "0.371"^^xsd:decimal ]
     ];
     fhir:Statistic.sampleSize [
       fhir:Statistic.sampleSize.note [
         fhir:index 0;
         fhir:Annotation.text [ fhir:value "Based on data from 6438 patients in 9 studies " ]
       ];
       fhir:Statistic.sampleSize.numberOfStudies [ fhir:value "9"^^xsd:integer ];
       fhir:Statistic.sampleSize.numberOfParticipants [ fhir:value "6438"^^xsd:integer ]
     ]
  ];
  fhir:Evidence.certainty [
     fhir:index 0;
     fhir:Evidence.certainty.description [ fhir:value "Low, due to serious imprecision and indirectness." ];
     fhir:Evidence.certainty.rating [
       fhir:index 0;
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-rating" ];
         fhir:Coding.code [ fhir:value "low" ];
         fhir:Coding.display [ fhir:value "Low quality" ]
       ]
     ];
     fhir:Evidence.certainty.certaintySubcomponent [
       fhir:index 0;
       fhir:Evidence.certainty.certaintySubcomponent.note [
         fhir:Annotation.text [ fhir:value "Note that all studies that reported 90 day to 1 year mortality also reported 28-30 day mortality: the CI 95% around the pooled effect for short term mortality also excludes no effect: RR 0.91 (CI 95% 0.84 - 0.98)." ]
       ];
       fhir:Evidence.certainty.certaintySubcomponent.type [
         fhir:index 0;
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type" ];
           fhir:Coding.code [ fhir:value "RiskOfBias" ];
           fhir:Coding.display [ fhir:value "Risk of bias" ]
         ]
       ];
       fhir:Evidence.certainty.certaintySubcomponent.rating [
         fhir:index 0;
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating" ];
           fhir:Coding.code [ fhir:value "no-concern" ];
           fhir:Coding.display [ fhir:value "no serious concern" ]
         ]
       ]
     ], [
       fhir:index 1;
       fhir:Evidence.certainty.certaintySubcomponent.type [
         fhir:index 0;
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type" ];
           fhir:Coding.code [ fhir:value "Inconsistency" ];
           fhir:Coding.display [ fhir:value "Inconsistency" ]
         ]
       ];
       fhir:Evidence.certainty.certaintySubcomponent.rating [
         fhir:index 0;
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating" ];
           fhir:Coding.code [ fhir:value "no-concern" ];
           fhir:Coding.display [ fhir:value "no serious concern" ]
         ]
       ]
     ], [
       fhir:index 2;
       fhir:Evidence.certainty.certaintySubcomponent.note [
         fhir:Annotation.text [ fhir:value "Only a small proportion of studies reported longer-term mortality." ]
       ];
       fhir:Evidence.certainty.certaintySubcomponent.type [
         fhir:index 0;
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type" ];
           fhir:Coding.code [ fhir:value "Indirectness" ];
           fhir:Coding.display [ fhir:value "Indirectness" ]
         ]
       ];
       fhir:Evidence.certainty.certaintySubcomponent.rating [
         fhir:index 0;
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating" ];
           fhir:Coding.code [ fhir:value "serious-concern" ];
           fhir:Coding.display [ fhir:value "serious concern" ]
         ]
       ]
     ], [
       fhir:index 3;
       fhir:Evidence.certainty.certaintySubcomponent.note [
         fhir:Annotation.text [ fhir:value "Confidence interval includes no effect." ]
       ];
       fhir:Evidence.certainty.certaintySubcomponent.type [
         fhir:index 0;
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type" ];
           fhir:Coding.code [ fhir:value "Imprecision" ];
           fhir:Coding.display [ fhir:value "Imprecision" ]
         ]
       ];
       fhir:Evidence.certainty.certaintySubcomponent.rating [
         fhir:index 0;
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating" ];
           fhir:Coding.code [ fhir:value "serious-concern" ];
           fhir:Coding.display [ fhir:value "serious concern" ]
         ]
       ]
     ], [
       fhir:index 4;
       fhir:Evidence.certainty.certaintySubcomponent.type [
         fhir:index 0;
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-type" ];
           fhir:Coding.code [ fhir:value "PublicationBias" ];
           fhir:Coding.display [ fhir:value "Publication bias" ]
         ]
       ];
       fhir:Evidence.certainty.certaintySubcomponent.rating [
         fhir:index 0;
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/certainty-subcomponent-rating" ];
           fhir:Coding.code [ fhir:value "no-concern" ];
           fhir:Coding.display [ fhir:value "no serious concern" ]
         ]
       ]
     ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/Evidence/Evidence-Example-MortalityLongTerm-NoCorticosteroids.ttl> a owl:Ontology;
  owl:imports fhir:fhir.ttl;
  owl:versionIRI <http://build.fhir.org/Evidence/Evidence-Example-MortalityLongTerm-NoCorticosteroids.ttl> .

# -------------------------------------------------------------------------------------


Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.