Evidence Based Medicine on FHIR Implementation Guide
2.0.0-ballot - ballot
Evidence Based Medicine on FHIR Implementation Guide
2.0.0-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 2.0.0-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
| Active as of 2022-09-06 |
Generated Narrative: Citation 104116
version: 14; Last updated: 2024-07-18 17:44:34+0000
Profile: JournalArticleCitation
identifier: FEvIR Object Identifier/104116, https://pubmed.ncbi.nlm.nih.gov/29340680, Uniform Resource Identifier (URI)/urn:oid:2.16.840.1.113883.4.642.40.44.15.38
version: 2.0.0-ballot
title: JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort
status: Active
date: 2022-09-06 14:07:55+0000
publisher: HL7 International / Clinical Decision Support
contact: HL7 International / Clinical Decision Support: http://www.hl7.org/Special/committees/dss
description:
This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide.
| Code | Value[x] |
| Citation Classification Type fevir-platform-use: FEvIR Platform Use | Project Specific |
jurisdiction: World
copyright:
https://creativecommons.org/licenses/by-nc-sa/4.0/
approvalDate: 2018-01-26
lastReviewDate: 2022-03-30
author: Brian S. Alper: , Computable Publishing®: MEDLINE-to-FEvIR Converter: , Joanne Dehnbostel:
| Style | Text |
| Computable Publishing | Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities [Journal Article]. Contributors: Jakobsen GS, Småstuen MC, Sandbu R, Nordstrand N, Hofsø D, Lindberg M, Hertel JK, Hjelmesæth J. In: JAMA, PMID 29340680. Published January 16, 2018. Available at: https://pubmed.ncbi.nlm.nih.gov/29340680/. |
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https://pubmed.ncbi.nlm.nih.gov/29340680, pii/2669729,https://doi.org/10.1001/jama.2017.21055,https://www.ncbi.nlm.nih.gov/pmc//PMC5833560Titles
Type Language Text Primary title English Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities.
Abstracts
Type Text Primary human use Importance: The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. Objective: To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Design, Setting, and Participants: Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (n = 2109) with severe obesity assessed (221 patients excluded and 1888 patients included). Exposures: Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs. Main Outcomes and Measures: Primary outcomes included remission and new onset of hypertension based on drugs dispensed according to the Norwegian Prescription Database. Prespecified secondary outcomes included changes in comorbidities. Adverse events included complications retrieved from the Norwegian Patient Registry and a local laboratory database. Results: Among 1888 patients included in the study, the mean (SD) age was 43.5 (12.3) years (1249 women [66%]; mean [SD] baseline BMI, 44.2 [6.1]; 100% completed follow-up at a median of 6.5 years [range, 0.2-10.1]). Surgically treated patients had a greater likelihood of remission and lesser likelihood for new onset of hypertension (remission: absolute risk [AR], 31.9% vs 12.4%); risk difference [RD], 19.5% [95% CI, 15.8%-23.2%], relative risk [RR], 2.1 [95% CI, 2.0-2.2]; new onset: AR, 3.5% vs 12.2%, RD, 8.7% [95% CI, 6.7%-10.7%], RR, 0.4 [95% CI, 0.3-0.5]; greater likelihood of diabetes remission: AR, 57.5% vs 14.8%; RD, 42.7% [95% CI, 35.8%-49.7%], RR, 3.9 [95% CI, 2.8-5.4]; greater risk of new-onset depression: AR, 8.9% vs 6.5%; RD, 2.4% [95% CI, 1.3%-3.5%], RR, 1.5 [95% CI, 1.4-1.7]; and treatment with opioids: AR, 19.4% vs 15.8%, RD, 3.6% [95% CI, 2.3%-4.9%], RR, 1.3 [95% CI, 1.2-1.4]). Surgical patients had a greater risk for undergoing at least 1 additional gastrointestinal surgical procedure (AR, 31.3% vs 15.5%; RD, 15.8% [95% CI, 13.1%-18.5%]; RR, 2.0 [95% CI, 1.7-2.4]). The proportion of patients with low ferritin levels was significantly greater in the surgical group (26% vs 12%, P < .001). Conclusions and Relevance: Among patients with severe obesity followed up for a median of 6.5 years, bariatric surgery compared with medical treatment was associated with a clinically important increased risk for complications, as well as lower risks of obesity-related comorbidities. The risk for complications should be considered in the decision-making process.
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contributorship
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entry
contributor: Jakobsen GS
forenameInitials: GS
affiliation: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.
entry
contributor: Småstuen MC
forenameInitials: MC
affiliation: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.
entry
contributor: Sandbu R
forenameInitials: R
affiliation:
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.
- Department of Surgery, Vestfold Hospital Trust, Tønsberg, Norway.
entry
contributor: Nordstrand N
forenameInitials: N
affiliation: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.
entry
contributor: Hofsø D
forenameInitials: D
affiliation: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.
entry
contributor: Lindberg M
forenameInitials: M
affiliation: Department of Laboratory Medicine, Vestfold Hospital Trust, Tønsberg, Norway.
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contributor: Hertel JK
forenameInitials: JK
affiliation: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.
entry
contributor: Hjelmesæth J
forenameInitials: J
affiliation:
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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Generated Narrative: Practitioner #contributor0
name: Gunn Signe Jakobsen
Generated Narrative: Practitioner #contributor1
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Generated Narrative: Practitioner #contributor2
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IG © 2024+ HL7 International / Clinical Decision Support. Package hl7.fhir.uv.ebm#2.0.0-ballot based on FHIR 6.0.0-ballot2. Generated 2024-11-01
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