{"certainty":[{"description":"Very low certainty due to risk of bias, inconsistency, imprecision, and indirectness","rating":{"coding":[{"code":"very-low","display":"Very low quality","system":"http://hl7.org/fhir/certainty-rating"}]},"subcomponent":[{"rating":{"coding":[{"code":"no-concern","display":"no serious concern","system":"http://hl7.org/fhir/certainty-rating"}]},"type":{"coding":[{"code":"PublicationBias","display":"Publication bias","system":"http://hl7.org/fhir/certainty-type"}]}},{"note":[{"text":"IST-3 had inconsistent results and contributed large proportion of data"}],"rating":{"coding":[{"code":"serious-concern","display":"serious concern","system":"http://hl7.org/fhir/certainty-rating"}]},"type":{"coding":[{"code":"Inconsistency","display":"Inconsistency","system":"http://hl7.org/fhir/certainty-type"}]}},{"note":[{"text":"results derived from figure with limited data reported to support the specific effect estimate; derived odds ratio in figure does not match results from rates of mRS 0-2 reported in Supplementary Figure 3b"}],"rating":{"coding":[{"code":"serious-concern","display":"serious concern","system":"http://hl7.org/fhir/certainty-rating"}]},"type":{"coding":[{"code":"Imprecision","display":"Imprecision","system":"http://hl7.org/fhir/certainty-type"}]}},{"note":[{"text":"resuts derived for 3 - 4.5 hours assume data from 0 - 6 hours is informative"}],"rating":{"coding":[{"code":"serious-concern","display":"serious concern","system":"http://hl7.org/fhir/certainty-rating"}]},"type":{"coding":[{"code":"Indirectness","display":"Indirectness","system":"http://hl7.org/fhir/certainty-type"}]}},{"note":[{"text":"results largely influenced by IST-3 trial which was unblinded and ECASS III which had baseline imbalances"}],"rating":{"coding":[{"code":"serious-concern","display":"serious concern","system":"http://hl7.org/fhir/certainty-rating"}]},"type":{"coding":[{"code":"RiskOfBias","display":"Risk of bias","system":"http://hl7.org/fhir/certainty-type"}]}}],"type":{"coding":[{"code":"Overall","display":"Overall certainty","system":"http://hl7.org/fhir/certainty-type"}]}}],"contact":[{"telecom":[{"system":"url"}]}],"description":"mRS 0-2 at 90 days Odds Ratio 1.2 for Alteplase vs. No Alteplase in patients with acute ischemic stroke 3-4.5 hours prior","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-wg","valueCode":"cds"}],"id":"example-stroke-3-4half-alteplase-vs-no-alteplase-mRS0-2","identifier":[{"system":"urn:ietf:rfc:3986","value":"urn:oid:2.16.840.1.113883.4.642.10.3"}],"name":"EffectOfAlteplaseVsNoAlteplaseOnMRS02At90DaysInStroke345HoursPrior","publisher":"HL7 International / Clinical Decision Support","relatedArtifact":[{"citation":"Lees KR, Emberson J, Blackwell L, Bluhmki E, Davis SM, Donnan GA, et al; Stroke Thrombolysis Trialists’ Collaborators Group. Effects of alteplase for acute stroke on the distribution of functional outcomes: a pooled analysis of 9 trials. Stroke. 2016;47:2373-2379. PMID 27507856","display":"Figure 2 Lees 2016","document":{"url":"https://doi.org/10.1161/STROKEAHA.116.013644"},"label":"Lees 2016","type":"citation"}],"resourceType":"Evidence","statistic":[{"attributeEstimate":[{"description":"95% CI 1.06 to 1.3","level":0.95,"range":{"high":{"value":1.3},"low":{"value":1.06}},"type":{"coding":[{"code":"C53324","display":"Confidence interval","system":"http://terminology.hl7.org/CodeSystem/attribute-estimate-type"}]}}],"quantity":{"value":1.2},"sampleSize":{"numberOfStudies":9},"statisticType":{"coding":[{"code":"C16932","display":"Odds Ratio","system":"http://terminology.hl7.org/CodeSystem/statistic-type"}]}}],"status":"draft","studyDesign":[{"coding":[{"code":"SEVCO:01003","display":"randomized assignment","system":"http://hl7.org/fhir/study-design"}]}],"synthesisType":{"coding":[{"code":"IPD-MA","display":"individual patient data meta-analysis","system":"http://terminology.hl7.org/CodeSystem/synthesis-type"}]},"text":{"div":"
\n "Effect of Alteplase vs No alteplase on mRS 0-2 at 90 days in Stroke 3-4.5 hours prior" is a comparative effect estimate.\n
\n\t\n