Release 5 Preview #1
Clinical ReasoningThis page is part of the FHIR Specification (v4.2.0: R5 Preview #1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions 
| Clinical Decision Support Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Not linked to any defined compartments |
Raw Turtle (+ also see Turtle/RDF Format Specification)
Corticosteroids vs 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/example> a fhir:Evidence;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "example"];
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>: example</p><p><b>title</b>: Corticosteroids vs 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>: Mortality reduced with RR 0.94 with Corticosteroids vs 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>: Corticosteroids</p><p><b>variableRole</b>: exposure <span>(Details : {http://terminology.hl7.org/CodeSystem/variable-role code 'exposure' = 'exposure', given as 'exposure'})</span></p><p><b>actualDefinition</b>: ???</p><p><b>intendedDefinition</b>: Corticosteroids</p><p><b>directnessMatch</b>: ??? <span>(Details : {http://terminology.hl7.org/CodeSystem/directness code 'null' = 'null', given as '???'})</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 "Corticosteroids vs 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 "Mortality reduced with RR 0.94 with Corticosteroids vs 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 "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 "exposure" ];
fhir:Coding.display [ fhir:value "exposure" ]
]
];
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 "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:index 2;
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 "Relative risk 0.94" ];
fhir:Statistic.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "Based on data from 6438 patients in 9 studies " ]
];
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 "C93152" ];
fhir:Coding.display [ fhir:value "relative risk" ]
]
];
fhir:Statistic.quantity [
fhir:Quantity.value [ fhir:value "0.94"^^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:Statistic.attributeEstimate [
fhir:index 0;
fhir:Statistic.attributeEstimate.description [ fhir:value "(CI 95% 0.89 - 1.00)" ];
fhir:Statistic.attributeEstimate.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/attribute-estimate-type" ];
fhir:Coding.code [ fhir:value "C53324" ];
fhir:Coding.display [ fhir:value "confidence interval" ]
]
];
fhir:Statistic.attributeEstimate.level [ fhir:value "0.95"^^xsd:decimal ];
fhir:Statistic.attributeEstimate.range [
fhir:Range.low [
fhir:Quantity.value [ fhir:value "0.89"^^xsd:decimal ]
];
fhir:Range.high [
fhir:Quantity.value [ fhir:value "1.00"^^xsd:decimal ]
]
]
]
], [
fhir:index 1;
fhir:Statistic.description [ fhir:value "Absolute risk difference: 22 fewer per 1000" ];
fhir:Statistic.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "Difference: 22 fewer per 1000" ]
];
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 "0000424" ];
fhir:Coding.display [ fhir:value "absolute risk difference" ]
]
];
fhir:Statistic.quantity [
fhir:Quantity.value [ fhir:value "0.022"^^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:Statistic.attributeEstimate [
fhir:index 0;
fhir:Statistic.attributeEstimate.description [ fhir:value "(CI 95% 0.041 - 0.00)" ];
fhir:Statistic.attributeEstimate.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/attribute-estimate-type" ];
fhir:Coding.code [ fhir:value "C53324" ];
fhir:Coding.display [ fhir:value "confidence interval" ]
]
];
fhir:Statistic.attributeEstimate.range [
fhir:Range.low [
fhir:Quantity.value [ fhir:value "0"^^xsd:decimal ]
];
fhir:Range.high [
fhir:Quantity.value [ fhir:value "0.041"^^xsd:decimal ]
]
]
]
];
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/example.ttl> a owl:Ontology;
owl:imports fhir:fhir.ttl;
owl:versionIRI <http://build.fhir.org/Evidence/example.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.
FHIR ®© HL7.org 2011+. FHIR CI Build hl7.fhir.core#4.2.0 (GitHub f996518d66) generated on Tue, Dec 31, 2019 21:12+1100.
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