Evidence Based Medicine on FHIR Implementation Guide
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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

: Certainty of Evidence Rating of 14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY) - XML Representation

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<ArtifactAssessment xmlns="http://hl7.org/fhir">
  <id value="179693"/>
  <meta>
    <versionId value="6"/>
    <lastUpdated value="2023-12-04T21:34:42.955Z"/>
    <profile
             value="http://hl7.org/fhir/uv/ebm/StructureDefinition/certainty-of-evidence"/>
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  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: ArtifactAssessment</b><a name="179693"> </a><a name="hc179693"> </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 &quot;179693&quot; Version &quot;6&quot; Updated &quot;2023-12-04 21:34:42+0000&quot; </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-certainty-of-evidence.html">CertaintyOfEvidence</a></p></div><p><b>Artifact URL</b>: <a href="https://fevir.net/resources/ArtifactAssessment/179693">https://fevir.net/resources/ArtifactAssessment/179693</a></p><p><b>Artifact Description</b>: This example of a CertaintyOfEvidence Profile shows a recursive pattern of component elements with type/classifier paired values for different aspects of rating the certainty of evidence.</p><p><b>identifier</b>: FEvIR Object Identifier/179693</p><p><b>title</b>: Certainty of Evidence Rating of 14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)</p><p><b>artifact</b>: <a href="Evidence-55.html">Evidence/55: 14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)</a> &quot;Fourteen_day_mortality_remdesivir_vs_placebo_meta_analysis_ACTT_1_Wang_et_al_WHO_SOLIDARITY&quot;</p><blockquote><p><b>content</b></p><p><b>informationType</b>: rating</p><p><b>summary</b>: Low certainty due to inconsistency and risk of bias</p><p><b>type</b>: Overall certainty <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-certainty-type.html">Evidence Certainty Type</a>#Overall)</span></p><p><b>classifier</b>: Low quality <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-certainty-rating.html">Evidence Certainty Rating</a>#low)</span></p><blockquote><p><b>component</b></p><p><b>informationType</b>: rating</p><p><b>type</b>: Publication bias <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-certainty-type.html">Evidence Certainty Type</a>#PublicationBias)</span></p><p><b>classifier</b>: no serious concern <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-certainty-rating.html">Evidence Certainty Rating</a>#no-concern)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: rating</p><p><b>summary</b>: There is a high degree of heterogeneity (I-squared = 73%). There is also inconsistency in findings between the fixed-effect and random-effects statistical models.</p><p><b>type</b>: Inconsistency <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-certainty-type.html">Evidence Certainty Type</a>#Inconsistency)</span></p><p><b>classifier</b>: serious concern <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-certainty-rating.html">Evidence Certainty Rating</a>#serious-concern)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: rating</p><p><b>summary</b>: Although the random-effects analysis finds an estimate without statistical significance, this imprecision is explained by the inconsistency (heterogeneity) and thus not further downrated in certainty assessment.</p><p><b>type</b>: Imprecision <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-certainty-type.html">Evidence Certainty Type</a>#Imprecision)</span></p><p><b>classifier</b>: no serious concern <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-certainty-rating.html">Evidence Certainty Rating</a>#no-concern)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: rating</p><p><b>type</b>: Indirectness <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-certainty-type.html">Evidence Certainty Type</a>#Indirectness)</span></p><p><b>classifier</b>: no serious concern <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-certainty-rating.html">Evidence Certainty Rating</a>#no-concern)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: rating</p><p><b>type</b>: Risk of bias <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-certainty-type.html">Evidence Certainty Type</a>#RiskOfBias)</span></p><p><b>classifier</b>: serious concern <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-certainty-rating.html">Evidence Certainty Rating</a>#serious-concern)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote></div>
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             url="http://hl7.org/fhir/StructureDefinition/artifact-description">
    <valueMarkdown
                   value="This example of a CertaintyOfEvidence Profile shows a recursive pattern of component elements with type/classifier paired values for different aspects of rating the certainty of evidence."/>
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  <title
         value="Certainty of Evidence Rating of 14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)"/>
  <artifactReference>🔗 
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    <type value="Evidence"/>
    <display
             value="14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)"/>
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    <informationType value="rating"/>
    <summary value="Low certainty due to inconsistency and risk of bias"/>
    <type>
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        <system value="http://hl7.org/fhir/certainty-type"/>
        <code value="Overall"/>
        <display value="Overall certainty"/>
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      <coding>
        <system value="http://hl7.org/fhir/certainty-rating"/>
        <code value="low"/>
        <display value="Low quality"/>
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          <system value="http://hl7.org/fhir/certainty-type"/>
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          <display value="Publication bias"/>
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          <system value="http://hl7.org/fhir/certainty-rating"/>
          <code value="no-concern"/>
          <display value="no serious concern"/>
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    <component>
      <informationType value="rating"/>
      <summary
               value="There is a high degree of heterogeneity (I-squared = 73%). There is also inconsistency in findings between the fixed-effect and random-effects statistical models."/>
      <type>
        <coding>
          <system value="http://hl7.org/fhir/certainty-type"/>
          <code value="Inconsistency"/>
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        <coding>
          <system value="http://hl7.org/fhir/certainty-rating"/>
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    <component>
      <informationType value="rating"/>
      <summary
               value="Although the random-effects analysis finds an estimate without statistical significance, this imprecision is explained by the inconsistency (heterogeneity) and thus not further downrated in certainty assessment."/>
      <type>
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          <system value="http://hl7.org/fhir/certainty-type"/>
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          <display value="Imprecision"/>
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          <system value="http://hl7.org/fhir/certainty-rating"/>
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          <system value="http://hl7.org/fhir/certainty-type"/>
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          <system value="http://hl7.org/fhir/certainty-rating"/>
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          <system value="http://hl7.org/fhir/certainty-type"/>
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          <display value="Risk of bias"/>
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        <coding>
          <system value="http://hl7.org/fhir/certainty-rating"/>
          <code value="serious-concern"/>
          <display value="serious concern"/>
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      </classifier>
      <component>
        <informationType value="rating"/>
        <summary
                 value="No blinding (no placebo control) in the largest trial"/>
        <type>
          <coding>
            <system value="https://fevir.net/resources/CodeSystem/181513"/>
            <code value="SEVCO:00035"/>
            <display value="Inadequate blinding of participants"/>
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          <text value="Lack of blinding"/>
        </type>
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          <coding>
            <system value="http://hl7.org/fhir/certainty-rating"/>
            <code value="present"/>
            <display value="present"/>
          </coding>
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      </component>
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