Evidence Based Medicine on FHIR Implementation Guide, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/ebm/ and changes regularly. See the Directory of published versions
Page standards status: Informative |
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:ArtifactAssessment ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "179469"] ; #
fhir:meta [
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fhir:lastUpdated [ fhir:v "2025-08-14T14:42:39.998Z"^^xsd:dateTime ] ;
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fhir:v "http://hl7.org/fhir/uv/ebm/StructureDefinition/recommendation-justification"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/uv/ebm/StructureDefinition/recommendation-justification> ] )
] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Title: </b>Justification for Recommendation: ADA Obesity Management Recommendation 8.16</p><br/><p><b>Justification for Recommendation: </b>Recommendation: ADA Obesity Management Recommendation 8.16</p><br/><table><tr><th>Concept</th><th>Summary</th><th>Rating</th></tr><tr><td>Evidence (coded as: evidence from https://fevir.net/resources/CodeSystem/179423)</td><td>ADA Level of Evidence A. A substantial body of evidence has now been accumulated, including data from numerous randomized controlled (nonblinded) clinical trials, demonstrating that metabolic surgery achieves superior glycemic control and reduction of cardiovascular risk factors in patients with type 2 diabetes and obesity compared with various lifestyle/medical interventions.</td><td>undefined</td></tr><tr><td>Summary of Findings (coded as: summary-of-findings from https://fevir.net/resources/CodeSystem/179423)</td><td>ADA Level of Evidence A. A substantial body of evidence has now been accumulated, including data from numerous randomized controlled (nonblinded) clinical trials, demonstrating that metabolic surgery achieves superior glycemic control and reduction of cardiovascular risk factors in patients with type 2 diabetes and obesity compared with various lifestyle/medical interventions.</td><td>undefined</td></tr><tr><td>Discussion (coded as: discussion from https://fevir.net/resources/CodeSystem/179423)</td><td>A substantial body of evidence has now been accumulated, including data from numerous randomized controlled (nonblinded) clinical trials, demonstrating that metabolic surgery achieves superior glycemic control and reduction of cardiovascular risk factors in patients with type 2 diabetes and obesity compared with various lifestyle/medical interventions.<br/>In extended follow-up of obese adults with type 2 diabetes randomized to adding gastric bypass compared with lifestyle and intensive medical management alone, there remained a significantly better composite triple end point in the surgical group at 5 years. However, because the effect size diminished over 5 years, further follow-up is needed to understand the durability of the improvement.</td><td>undefined</td></tr><tr><td>Competing Interests (coded as: competing-interests from https://fevir.net/resources/CodeSystem/179423)</td><td>All members of the PPC are required to disclose potential conflicts of interest with industry and other relevant organizations. These disclosures are discussed at the outset of each Standards of Care revision meeting. Members of the committee, their employers, and their disclosed conflicts of interest are listed in 'Disclosures: Standards of Medical Care in Diabetes—2021' (https://doi.org/10.2337/dc21-SPPC). The ADA funds development of the Standards of Care out of its general revenues and does not use industry support for this purpose. NOTE: The disclosed conflicts of interest was not found at the suggested URL</td><td>undefined</td></tr></table><br/></div>"^^rdf:XMLLiteral
] ; #
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/artifact-description"^^xsd:anyURI ] ;
fhir:value [
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fhir:v "An example using the ArtifactAssessment Resource for representation of the many judgments and concepts used to justify a recommendation." ]
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fhir:code [ fhir:v "active" ] ;
fhir:display [ fhir:v "Active" ] ] ) ]
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fhir:assigner [
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fhir:title [ fhir:v "Justification for Recommendation: ADA Obesity Management Recommendation 8.16"] ; #
fhir:citeAs [ fhir:v "Justification for Recommendation: ADA Obesity Management Recommendation 8.16 [Database Entry: FHIR ArtifactAssessment Resource]. Contributors: In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 179469. Revised 2025-08-14. Available at: https://fevir.net/resources/ArtifactAssessment/179469. Computable resource at: https://fevir.net/resources/ArtifactAssessment/179469#json."] ; #
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fhir:display [ fhir:v "Recommendation: ADA Obesity Management Recommendation 8.16" ]
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fhir:reference [ fhir:v "Citation/33089" ] ;
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fhir:reference [ fhir:v "Evidence/33244" ] ;
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fhir:summary [ fhir:v "A substantial body of evidence has now been accumulated, including data from numerous randomized controlled (nonblinded) clinical trials, demonstrating that metabolic surgery achieves superior glycemic control and reduction of cardiovascular risk factors in patients with type 2 diabetes and obesity compared with various lifestyle/medical interventions.<br/>In extended follow-up of obese adults with type 2 diabetes randomized to adding gastric bypass compared with lifestyle and intensive medical management alone, there remained a significantly better composite triple end point in the surgical group at 5 years. However, because the effect size diminished over 5 years, further follow-up is needed to understand the durability of the improvement." ] ;
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fhir:v "Sjöström L, Peltonen M, Jacobson P, et al. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA 2014;311:2297–2304" ] ] [
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fhir:display [ fhir:v "ComparativeEvidence: Bariatric Surgery effect for ADA triple outcome at 5 years (Diabetes Surgery Study)" ] ] ] ) ;
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] ) . #
IG © 2024+ HL7 International / Clinical Decision Support. Package hl7.fhir.uv.ebm#1.0.0-ballot2 based on FHIR 6.0.0-ballot3. Generated 2025-09-04
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