This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
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Clinical Decision Support Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: No defined compartments |
Raw XML (canonical form + also see XML Format Specification)
Effect of Alteplase vs No alteplase on mRS 0-2 at 90 days in Stroke 3-4.5 hours prior (id = "example-stroke-3-4half-alteplase-vs-no-alteplase-mRS0-2")
<?xml version="1.0" encoding="UTF-8"?> <Evidence xmlns="http://hl7.org/fhir"> <id value="example-stroke-3-4half-alteplase-vs-no-alteplase-mRS0-2"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p> "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. </p> </div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="cds"/> </extension> <url value="http://hl7.org/fhir/Evidence/example-stroke-3-4half-alteplase-vs-no-alteplase-mRS0-2"/> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:oid:2.16.840.1.113883.4.642.10.3"/> </identifier> <name value="EffectOfAlteplaseVsNoAlteplaseOnMRS02At90DaysInStroke345HoursPrior"/> <title value="Effect of Alteplase vs No alteplase on mRS 0-2 at 90 days in Stroke 3-4.5 hours prior"/> <status value="draft"/> <publisher value="HL7 International / Clinical Decision Support"/> <contact> <telecom> <system value="url"/> <value value="http://www.hl7.org/Special/committees/dss"/> </telecom> </contact> <relatedArtifact> <type value="citation"/> <label value="Lees 2016"/> <display value="Figure 2 Lees 2016"/> <citation value="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"/> <document> <url value="https://doi.org/10.1161/STROKEAHA.116.013644"/> </document> </relatedArtifact> <description value="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"/> <variableDefinition> <variableRole value="population"/> <observed> <reference value="EvidenceVariable/Stroke-Thrombolysis-Trialists-2014-2016-IPD-MA-Cohort"/> <type value="EvidenceVariable"/> <display value="Stroke Thrombolysis Trialists’ 2014-2016 IPD-MA Cohort"/> </observed> <intended> <reference value="Group/AcuteIschemicStroke3-4halfHours"/> <type value="Group"/> <display value="stroke at 3-4.5 hours"/> </intended> <directnessMatch> <coding> <system value="http://terminology.hl7.org/CodeSystem/directness"/> <code value="moderate"/> <display value="Moderate quality match between observed and intended variable"/> </coding> </directnessMatch> </variableDefinition> <variableDefinition> <variableRole value="outcome"/> <observed> <reference value="EvidenceVariable/example-mRS0-2-at-90days"/> <type value="EvidenceVariable"/> <display value="mRS 0-2 at 90 days"/> </observed> <intended> <reference value="EvidenceVariable/example-alive-independent-90day"/> <type value="EvidenceVariable"/> <display value="Alive and not functionally dependent at 90 days"/> </intended> </variableDefinition> <variableDefinition> <variableRole value="exposure"/> <comparatorCategory value="No Alteplase"/> <observed> <reference value="EvidenceVariable/example-group-assignment-alteplase-for-stroke-vs-no-alteplase"/> <type value="EvidenceVariable"/> <display value="Group Assignment: Alteplase for Stroke vs No Alteplase"/> </observed> </variableDefinition> <synthesisType> <coding> <system value="http://terminology.hl7.org/CodeSystem/synthesis-type"/> <code value="IPD-MA"/> <display value="individual patient data meta-analysis"/> </coding> </synthesisType> <studyDesign> <coding> <system value="http://hl7.org/fhir/study-design"/> <code value="SEVCO:01003"/> <display value="randomized assignment"/> </coding> </studyDesign> <statistic> <statisticType> <coding> <system value="http://terminology.hl7.org/CodeSystem/statistic-type"/> <code value="C16932"/> <display value="Odds Ratio"/> </coding> </statisticType> <quantity> <value value="1.2"/> </quantity> <sampleSize> <numberOfStudies value="9"/> </sampleSize> <attributeEstimate> <description value="95% CI 1.06 to 1.3"/> <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="1.06"/> </low> <high> <value value="1.3"/> </high> </range> </attributeEstimate> </statistic> <certainty> <description value="Very low certainty due to risk of bias, inconsistency, imprecision, and indirectness"/> <type> <coding> <system value="http://hl7.org/fhir/certainty-type"/> <code value="Overall"/> <display value="Overall certainty"/> </coding> </type> <rating> <coding> <system value="http://hl7.org/fhir/certainty-rating"/> <code value="very-low"/> <display value="Very low quality"/> </coding> </rating> <subcomponent> <type> <coding> <system value="http://hl7.org/fhir/certainty-type"/> <code value="PublicationBias"/> <display value="Publication bias"/> </coding> </type> <rating> <coding> <system value="http://hl7.org/fhir/certainty-rating"/> <code value="no-concern"/> <display value="no serious concern"/> </coding> </rating> </subcomponent> <subcomponent> <note> <text value="IST-3 had inconsistent results and contributed large proportion of data"/> </note> <type> <coding> <system value="http://hl7.org/fhir/certainty-type"/> <code value="Inconsistency"/> <display value="Inconsistency"/> </coding> </type> <rating> <coding> <system value="http://hl7.org/fhir/certainty-rating"/> <code value="serious-concern"/> <display value="serious concern"/> </coding> </rating> </subcomponent> <subcomponent> <note> <text value="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"/> </note> <type> <coding> <system value="http://hl7.org/fhir/certainty-type"/> <code value="Imprecision"/> <display value="Imprecision"/> </coding> </type> <rating> <coding> <system value="http://hl7.org/fhir/certainty-rating"/> <code value="serious-concern"/> <display value="serious concern"/> </coding> </rating> </subcomponent> <subcomponent> <note> <text value="resuts derived for 3 - 4.5 hours assume data from 0 - 6 hours is informative"/> </note> <type> <coding> <system value="http://hl7.org/fhir/certainty-type"/> <code value="Indirectness"/> <display value="Indirectness"/> </coding> </type> <rating> <coding> <system value="http://hl7.org/fhir/certainty-rating"/> <code value="serious-concern"/> <display value="serious concern"/> </coding> </rating> </subcomponent> <subcomponent> <note> <text value="results largely influenced by IST-3 trial which was unblinded and ECASS III which had baseline imbalances"/> </note> <type> <coding> <system value="http://hl7.org/fhir/certainty-type"/> <code value="RiskOfBias"/> <display value="Risk of bias"/> </coding> </type> <rating> <coding> <system value="http://hl7.org/fhir/certainty-rating"/> <code value="serious-concern"/> <display value="serious concern"/> </coding> </rating> </subcomponent> </certainty> </Evidence>
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.
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