Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot - ballot
Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot - ballot
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-ballot 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
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<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: ArtifactAssessment</b><a name="179515"> </a><a name="hc179515"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">ResourceArtifactAssessment "179515" Version "7" Updated "2024-04-17 19:54:55+0000" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-recommendation-justification.html">RecommendationJustification</a></p></div><p><b>Artifact URL</b>: <a href="https://fevir.net/resources/ArtifactAssessment/179515">https://fevir.net/resources/ArtifactAssessment/179515</a></p><p><b>Artifact Description</b>: An example using the ArtifactAssessment Resource for representation of the many judgments and concepts used to justify a recommendation.</p><p><b>identifier</b>: FEvIR Object Identifier/179515</p><p><b>title</b>: Justification for Recommendation: ADA Obesity Management Recommendation 8.17</p><p><b>citeAs</b>: Justification for Recommendation: ADA Obesity Management Recommendation 8.17 [Database Entry: FHIR ArtifactAssessment Resource]. Contributors: In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 179515. Revised 2024-04-17. Available at: https://fevir.net/resources/ArtifactAssessment/179515. Computable resource at: https://fevir.net/resources/ArtifactAssessment/179515.</p><p><b>artifact</b>: <a href="Composition-179467.html">Composition/179467: Recommendation: ADA Obesity Management Recommendation 8.17</a></p><blockquote><p><b>content</b></p><p><b>informationType</b>: container</p><p><b>summary</b>: 8.17 Metabolic surgery may be considered as an option to treat type 2 diabetes in adults with BMI 30.0–34.9 kg/m2 (27.5–32.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods. A</p><p><b>type</b>: Recommendation Specification <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-content0; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#recommendation-specification)</span></p><h3>RelatedArtifacts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td><td><b>Citation</b></td><td><b>ResourceReference</b></td></tr><tr><td style="display: none">*</td><td>derived-from</td><td>Guideline <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span>, Citation Resource <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>8. Obesity Management for the Treatment of Type 2 Diabetes: Standards of Medical Care in Diabetes-2021 [Journal Article]. Contributors: American Diabetes Association. In: Diabetes care, PMID 33298419. Published January 2021. Available at: https://pubmed.ncbi.nlm.nih.gov/33298419/.</td><td><a href="Citation-32137.html">Citation/32137: JournalArticleCitation: ADA 2021 Standards of Medical Care 8. Obesity Management for the Treatment of Type 2 Diabetes</a></td></tr></table><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>informationType</b>: comment</p><p><b>summary</b>: 8.17 Metabolic surgery may be considered as an option to treat type 2 diabetes in adults with BMI 30.0–34.9 kg/m2 (27.5–32.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods. A</p><p><b>type</b>: Recommendation Statement <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#recommendation-statement)</span></p><p><b>freeToShare</b>: true</p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: Rating System <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#rating-system)</span></p><p><b>classifier</b>: ADA Level of Evidence <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>freeToShare</b>: true</p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: Strength of Recommendation <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1000; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#strength-of-recommendation)</span></p><p><b>freeToShare</b>: true</p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: Direction of Recommendation <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1014; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#direction-of-recommendation)</span></p><p><b>classifier</b>: Favors intervention <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-2021)</span></p><p><b>freeToShare</b>: true</p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: Ratings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#ratings)</span></p><p><b>classifier</b>: A <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>freeToShare</b>: true</p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: Discussion <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#discussion)</span></p><p><b>freeToShare</b>: true</p></blockquote><blockquote><p><b>component</b></p><p><b>summary</b>: Inclusion Criteria: [[1]] Adults. [[2]] Diagnosed with type 2 diabetes. [[3]] Body Mass Index (BMI) ≥ 30.0 kg/m2 and ≤ 34.9 kg/m2 (BMI 27.5-32.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods. [[4]] Screened surgical candidates.</p><p><b>type</b>: Population <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1015; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#population)</span></p><blockquote><p><b>relatedArtifact</b></p></blockquote><p><b>freeToShare</b>: true</p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: Action <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1016; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#action)</span></p><p><b>freeToShare</b>: true</p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: Opposite Action <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1017; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#opposite-action)</span></p><p><b>freeToShare</b>: true</p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: container</p><p><b>summary</b>: 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.</p><p><b>type</b>: Evidence <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-content1; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#evidence)</span></p><h3>RelatedArtifacts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td><td><b>Citation</b></td><td><b>ResourceReference</b></td></tr><tr><td style="display: none">*</td><td>justification</td><td>Guideline <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span>, Citation Resource <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>Rubino F, Nathan DM, Eckel RH, et al.; Delegates of the 2nd Diabetes Surgery Summit. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Diabetes Care 2016;39:861–877</td><td><a href="Citation-33089.html">Citation/33089: JournalArticleCitation: Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations</a></td></tr><tr><td style="display: none">*</td><td>justification</td><td>Evidence Resource <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>derived from Figure 2C of: Rubino F, Nathan DM, Eckel RH, et al.; Delegates of the 2nd Diabetes Surgery Summit. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Diabetes Care 2016;39:861–877</td><td><a href="Evidence-33244.html">Evidence/33244: ComparativeEvidence: Mean difference in HbA1c effect of bariatric surgery in 2016 meta-analysis</a> "MeanDiffA1c2016metaAnalysis"</td></tr></table><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>summary</b>: 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.</p><p><b>type</b>: Summary of Findings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#summary-of-findings)</span></p><p><b>freeToShare</b>: true</p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: Desirable Effects <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1004; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#desirable-effects)</span></p><p><b>freeToShare</b>: true</p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: Undesirable Effects <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1005; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#undesirable-effects)</span></p><p><b>freeToShare</b>: true</p></blockquote><blockquote><p><b>component</b></p><p><b>summary</b>: 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.</p><p><b>type</b>: Discussion <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#discussion)</span></p><blockquote><p><b>relatedArtifact</b></p></blockquote><blockquote><p><b>relatedArtifact</b></p></blockquote><blockquote><p><b>relatedArtifact</b></p></blockquote><p><b>freeToShare</b>: true</p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: container</p><p><b>type</b>: Net Effect <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1007; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#net-effect)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>FreeToShare</b></td></tr><tr><td style="display: none">*</td><td>Values/Preferences <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1006; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#preferences "Preferences")</span></td><td>true</td></tr><tr><td style="display: none">*</td><td>Discussion <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#discussion)</span></td><td>true</td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: container</p><p><b>type</b>: Judgments <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-content2; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#judgments)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>FreeToShare</b></td></tr><tr><td style="display: none">*</td><td>Justification <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#justification)</span></td><td>true</td></tr><tr><td style="display: none">*</td><td>Problem Importance <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1003; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#problem-importance)</span></td><td>true</td></tr><tr><td style="display: none">*</td><td>Resources/Costs <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1008; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#costs "Costs")</span></td><td>true</td></tr><tr><td style="display: none">*</td><td>Cost-effectiveness <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1009; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#cost-effectiveness)</span></td><td>true</td></tr><tr><td style="display: none">*</td><td>Equity <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1010; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#equity)</span></td><td>true</td></tr><tr><td style="display: none">*</td><td>Acceptability <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1011; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#acceptability)</span></td><td>true</td></tr><tr><td style="display: none">*</td><td>Feasibility <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1012; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#feasibility)</span></td><td>true</td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: container</p><p><b>type</b>: Considerations <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-content3; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#considerations)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Summary</b></td><td><b>Type</b></td><td><b>FreeToShare</b></td></tr><tr><td style="display: none">*</td><td> </td><td>Subgroup Considerations <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1019; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#subgroup-considerations)</span></td><td>true</td></tr><tr><td style="display: none">*</td><td> </td><td>Implementation Considerations <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1020; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#implementation-considerations)</span></td><td>true</td></tr><tr><td style="display: none">*</td><td> </td><td>Monitoring Considerations <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1021; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#monitoring-considerations)</span></td><td>true</td></tr><tr><td style="display: none">*</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>Competing Interests <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1002; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#competing-interests)</span></td><td>true</td></tr><tr><td style="display: none">*</td><td> </td><td>Research Priorities <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-27834.html">Recommendation Justification Code System</a>#RJCS-1022; <a href="CodeSystem-179423.html">Evidence Based Medicine on FHIR Implementation Guide Code System</a>#research-considerations "Research Considerations")</span></td><td>true</td></tr></table></blockquote></div>
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<summary
value="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"/>
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IG © 2022+ HL7 International / Clinical Decision Support. Package hl7.fhir.uv.ebm#1.0.0-ballot based on FHIR 5.0.0. Generated 2024-05-16
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