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 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

: JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

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fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Citation 104116</b></p><a name=\"104116\"> </a><a name=\"hc104116\"> </a><a name=\"104116-en-US\"> </a><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\">version: 14; Last updated: 2024-07-18 17:44:34+0000</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-journal-article-citation.html\">JournalArticleCitation</a></p></div><p><b>url</b>: <a href=\"Citation-104116.html\">Citation JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort</a></p><p><b>identifier</b>: FEvIR Object Identifier/104116, <code>https://pubmed.ncbi.nlm.nih.gov</code>/29340680, <a href=\"http://terminology.hl7.org/6.0.2/NamingSystem-uri.html\" title=\"As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt \r\n\r\nThis oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid: \r\n\r\nNote that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.\r\n\r\nThis OID may also be used in CD.codeSystem.\">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.4.642.40.44.15.38</p><p><b>version</b>: 2.0.0-ballot</p><p><b>title</b>: JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort</p><p><b>status</b>: Active</p><p><b>date</b>: 2022-09-06 14:07:55+0000</p><p><b>publisher</b>: HL7 International / Clinical Decision Support</p><p><b>contact</b>: HL7 International / Clinical Decision Support: <a href=\"http://www.hl7.org/Special/committees/dss\">http://www.hl7.org/Special/committees/dss</a></p><p><b>description</b>: </p><div><p>This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide.</p>\n</div><h3>UseContexts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-citation-classification-type.html#citation-classification-type-fevir-platform-use\">Citation Classification Type fevir-platform-use</a>: FEvIR Platform Use</td><td><span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier project-specific}\">Project Specific</span></td></tr></table><p><b>jurisdiction</b>: <span title=\"Codes:{http://unstats.un.org/unsd/methods/m49/m49.htm 001}\">World</span></p><p><b>copyright</b>: </p><div><p>https://creativecommons.org/licenses/by-nc-sa/4.0/</p>\n</div><p><b>approvalDate</b>: 2018-01-26</p><p><b>lastReviewDate</b>: 2022-03-30</p><p><b>author</b>: Brian S. Alper: , Computable Publishing®: MEDLINE-to-FEvIR Converter: , Joanne Dehnbostel: </p><h3>Summaries</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Style</b></td><td><b>Text</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://hl7.org/fhir/citation-summary-style comppub}\">Computable Publishing</span></td><td><div><p>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/.</p>\n</div></td></tr></table><blockquote><p><b>classification</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-classification-type citation-source}\">Citation Source</span></p><p><b>classifier</b>: <span title=\"Codes:\">MEDLINE</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-classification-type medline-owner}\">MEDLINE Citation Owner</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#owner_value NLM}\">National Library of Medicine, Index Section</span></p></blockquote><p><b>currentState</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-status-type medline-medline}\">Medline Citation Status of MEDLINE</span>, <span title=\"Codes:{http://hl7.org/fhir/citation-status-type pubmed-publication-status-ppublish}\">PubMed PublicationStatus of ppublish</span></p><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-entrez}\">PubMed Pubstatus of Entrez</span></p><p><b>period</b>: ?? --&gt; 2018-01-18 06:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-pubmed}\">PubMed Pubstatus of PubMed</span></p><p><b>period</b>: ?? --&gt; 2018-01-18 06:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-medline}\">PubMed Pubstatus of Medline</span></p><p><b>period</b>: ?? --&gt; 2018-01-27 06:00:00+0000</p></blockquote><blockquote><p><b>citedArtifact</b></p><p><b>identifier</b>: <code>https://pubmed.ncbi.nlm.nih.gov</code>/29340680, pii/2669729, <code>https://doi.org</code>/10.1001/jama.2017.21055, <code>https://www.ncbi.nlm.nih.gov/pmc/</code>/PMC5833560</p><h3>Titles</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Language</b></td><td><b>Text</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://hl7.org/fhir/title-type primary}\">Primary title</span></td><td><span title=\"Codes:{urn:ietf:bcp:47 en}\">English</span></td><td><div><p>Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities.</p>\n</div></td></tr></table><h3>Abstracts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Text</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://hl7.org/fhir/cited-artifact-abstract-type primary-human-use}\">Primary human use</span></td><td><div><p><strong>Importance:</strong> The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain.\n<strong>Objective:</strong> 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.\n<strong>Design, Setting, and Participants:</strong> 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).\n<strong>Exposures:</strong> Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs.\n<strong>Main Outcomes and Measures:</strong> 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.\n<strong>Results:</strong> 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 &lt; .001).\n<strong>Conclusions and Relevance:</strong> 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.</p>\n</div></td></tr></table><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>J Affect Disord. 2015 Mar 15;174:644-9</p>\n</div><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/25577158/\">https://pubmed.ncbi.nlm.nih.gov/25577158/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/25577158</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>N Engl J Med. 2016 Jul 28;375(4):311-22</p>\n</div><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/27295427/\">https://pubmed.ncbi.nlm.nih.gov/27295427/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/27295427</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>N Engl J Med. 2017 Jan 19;376(3):254-266</p>\n</div><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/28099824/\">https://pubmed.ncbi.nlm.nih.gov/28099824/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/28099824</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>JAMA Surg. 2015 Apr;150(4):352-61</p>\n</div><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/25650964/\">https://pubmed.ncbi.nlm.nih.gov/25650964/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/25650964</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Obesity (Silver Spring). 2015 Jan;23(1):37-45</p>\n</div><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/25174845/\">https://pubmed.ncbi.nlm.nih.gov/25174845/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/25174845</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>JAMA. 2016 Jan 12;315(2):150-63</p>\n</div><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/26757464/\">https://pubmed.ncbi.nlm.nih.gov/26757464/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/26757464</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>JAMA. 1998 Nov 18;280(19):1690-1</p>\n</div><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/9832001/\">https://pubmed.ncbi.nlm.nih.gov/9832001/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/9832001</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>JAMA Surg. 2016 Jun 1;151(6):504-11</p>\n</div><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/26747510/\">https://pubmed.ncbi.nlm.nih.gov/26747510/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/26747510</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>BMJ. 2013 Oct 22;347:f5934</p>\n</div><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/24149519/\">https://pubmed.ncbi.nlm.nih.gov/24149519/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/24149519</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Basic Clin Pharmacol Toxicol. 2010 Feb;106(2):86-94</p>\n</div><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/19961477/\">https://pubmed.ncbi.nlm.nih.gov/19961477/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/19961477</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Surg Obes Relat Dis. 2017 Jun;13(6):962-969</p>\n</div><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/28209533/\">https://pubmed.ncbi.nlm.nih.gov/28209533/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/28209533</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Lancet. 2016 Mar 5;387(10022):957-967</p>\n</div><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/26724178/\">https://pubmed.ncbi.nlm.nih.gov/26724178/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/26724178</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Surg Obes Relat Dis. 2017 Oct;13(10 ):1743-1751</p>\n</div><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/28728833/\">https://pubmed.ncbi.nlm.nih.gov/28728833/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/28728833</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>JAMA. 2012 Sep 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title=\"Codes:{https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#citationsubset IM}\">IM</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">MeSH heading</span></p><p><b>artifactAssessment</b>: <a href=\"#hc104116/meshHeading0\">ArtifactAssessment: artifact[x] = this resource</a></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type knowledge-artifact-type}\">Knowledge Artifact Type</span></p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>artifactAssessment</b>: Classifier added by Computable Publishing LLC</p></blockquote><blockquote><p><b>contributorship</b></p><p><b>complete</b>: true</p><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc104116/contributor0\">Jakobsen GS</a></p><p><b>forenameInitials</b>: GS</p><p><b>affiliation</b>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc104116/contributor1\">Småstuen MC</a></p><p><b>forenameInitials</b>: MC</p><p><b>affiliation</b>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc104116/contributor2\">Sandbu R</a></p><p><b>forenameInitials</b>: R</p><p><b>affiliation</b>: </p><ul><li>Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</li><li>Department of Surgery, Vestfold Hospital Trust, Tønsberg, Norway.</li></ul></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc104116/contributor3\">Nordstrand N</a></p><p><b>forenameInitials</b>: N</p><p><b>affiliation</b>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc104116/contributor4\">Hofsø D</a></p><p><b>forenameInitials</b>: D</p><p><b>affiliation</b>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc104116/contributor5\">Lindberg M</a></p><p><b>forenameInitials</b>: M</p><p><b>affiliation</b>: Department of Laboratory Medicine, Vestfold Hospital Trust, Tønsberg, Norway.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc104116/contributor6\">Hertel JK</a></p><p><b>forenameInitials</b>: JK</p><p><b>affiliation</b>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc104116/contributor7\">Hjelmesæth J</a></p><p><b>forenameInitials</b>: J</p><p><b>affiliation</b>: </p><ul><li>Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</li><li>Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.</li></ul></blockquote></blockquote></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: ArtifactAssessment  #meshHeading0</b></p><a name=\"104116/meshHeading0\"> </a><a name=\"hc104116/meshHeading0\"> </a><a name=\"104116/meshHeading0-en-US\"> </a><p><b>artifact</b>: <a href=\"#hc104116\">Citation JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort</a></p><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D000328}\">Adult</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>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D050110}\">Bariatric Surgery</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:\">is Major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ Q000009}\">adverse effects</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">is Major topic</span></td><td><span title=\"Codes:{https://ncithesaurus.nci.nih.gov/ncitbrowser C49487}\">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D015992}\">Body Mass Index</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>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D015331}\">Cohort Studies</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>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D015897}\">Comorbidity</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>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D003863}\">Depression</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:\">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ Q000150}\">complications</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">is Major topic</span></td><td><span title=\"Codes:{https://ncithesaurus.nci.nih.gov/ncitbrowser C49487}\">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D003924}\">Diabetes Mellitus, Type 2</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:\">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ Q000150}\">complications</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">is Major topic</span></td><td><span title=\"Codes:{https://ncithesaurus.nci.nih.gov/ncitbrowser C49487}\">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D005260}\">Female</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>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D005293}\">Ferritins</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:\">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ Q000097}\">blood</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">is Major topic</span></td><td><span title=\"Codes:{https://ncithesaurus.nci.nih.gov/ncitbrowser C49487}\">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D006801}\">Humans</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>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D006973}\">Hypertension</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:\">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ Q000150}\">complications</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">is Major topic</span></td><td><span title=\"Codes:{https://ncithesaurus.nci.nih.gov/ncitbrowser C49487}\">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D008297}\">Male</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>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D008875}\">Middle Aged</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>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D009767}\">Obesity, Morbid</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:\">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ Q000150}\">complications</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">is Major topic</span></td><td><span title=\"Codes:{https://ncithesaurus.nci.nih.gov/ncitbrowser C49488}\">Yes</span></td></tr></table></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ Q000188}\">drug therapy</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">is Major topic</span></td><td><span title=\"Codes:{https://ncithesaurus.nci.nih.gov/ncitbrowser C49487}\">No</span></td></tr></table></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ Q000601}\">surgery</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">is Major topic</span></td><td><span title=\"Codes:{https://ncithesaurus.nci.nih.gov/ncitbrowser C49487}\">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D012074}\">Remission Induction</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>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Classifier</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://meshb.nlm.nih.gov/ D016896}\">Treatment Outcome</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>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner  #contributor0</b></p><a name=\"104116/contributor0\"> </a><a name=\"hc104116/contributor0\"> </a><a name=\"104116/contributor0-en-US\"> </a><p><b>name</b>: Gunn Signe Jakobsen </p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner  #contributor1</b></p><a name=\"104116/contributor1\"> </a><a name=\"hc104116/contributor1\"> </a><a name=\"104116/contributor1-en-US\"> </a><p><b>name</b>: Milada Cvancarova Småstuen </p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner  #contributor2</b></p><a name=\"104116/contributor2\"> </a><a name=\"hc104116/contributor2\"> </a><a name=\"104116/contributor2-en-US\"> </a><p><b>name</b>: Rune Sandbu </p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner  #contributor3</b></p><a name=\"104116/contributor3\"> </a><a name=\"hc104116/contributor3\"> </a><a name=\"104116/contributor3-en-US\"> </a><p><b>name</b>: Njord Nordstrand </p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner  #contributor4</b></p><a name=\"104116/contributor4\"> </a><a name=\"hc104116/contributor4\"> </a><a name=\"104116/contributor4-en-US\"> </a><p><b>name</b>: Dag Hofsø </p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner  #contributor5</b></p><a name=\"104116/contributor5\"> </a><a name=\"hc104116/contributor5\"> </a><a name=\"104116/contributor5-en-US\"> </a><p><b>name</b>: Morten Lindberg </p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner  #contributor6</b></p><a name=\"104116/contributor6\"> </a><a name=\"hc104116/contributor6\"> </a><a name=\"104116/contributor6-en-US\"> </a><p><b>name</b>: Jens Kristoffer Hertel </p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner  #contributor7</b></p><a name=\"104116/contributor7\"> </a><a name=\"hc104116/contributor7\"> </a><a name=\"104116/contributor7-en-US\"> </a><p><b>name</b>: Jøran Hjelmesæth </p></blockquote></div>"
  ] ; # 
  fhir:contained ( [
a fhir:ArtifactAssessment ;
fhir:id [ fhir:v "meshHeading0" ] ;
fhir:artifact [
a fhir:Reference ;
fhir:reference [ fhir:v "#" ] ;
fhir:type [ fhir:v "Citation"^^xsd:anyURI ]     ] ;
    ( fhir:content [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D000328" ] ;
fhir:display [ fhir:v "Adult" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D050110" ] ;
fhir:display [ fhir:v "Bariatric Surgery" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is Major topic" ]         ] )       ] [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
          ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Q000009" ] ;
fhir:display [ fhir:v "adverse effects" ]           ] )         ] ) ;
        ( fhir:component [
fhir:type [
fhir:text [ fhir:v "is Major topic" ]           ] ;
          ( fhir:classifier [
            ( fhir:coding [
fhir:system [ fhir:v "https://ncithesaurus.nci.nih.gov/ncitbrowser"^^xsd:anyURI ] ;
fhir:code [ fhir:v "C49487" ] ;
fhir:display [ fhir:v "No" ]             ] )           ] )         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D015992" ] ;
fhir:display [ fhir:v "Body Mass Index" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D015331" ] ;
fhir:display [ fhir:v "Cohort Studies" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D015897" ] ;
fhir:display [ fhir:v "Comorbidity" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D003863" ] ;
fhir:display [ fhir:v "Depression" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
          ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Q000150" ] ;
fhir:display [ fhir:v "complications" ]           ] )         ] ) ;
        ( fhir:component [
fhir:type [
fhir:text [ fhir:v "is Major topic" ]           ] ;
          ( fhir:classifier [
            ( fhir:coding [
fhir:system [ fhir:v "https://ncithesaurus.nci.nih.gov/ncitbrowser"^^xsd:anyURI ] ;
fhir:code [ fhir:v "C49487" ] ;
fhir:display [ fhir:v "No" ]             ] )           ] )         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D003924" ] ;
fhir:display [ fhir:v "Diabetes Mellitus, Type 2" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
          ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Q000150" ] ;
fhir:display [ fhir:v "complications" ]           ] )         ] ) ;
        ( fhir:component [
fhir:type [
fhir:text [ fhir:v "is Major topic" ]           ] ;
          ( fhir:classifier [
            ( fhir:coding [
fhir:system [ fhir:v "https://ncithesaurus.nci.nih.gov/ncitbrowser"^^xsd:anyURI ] ;
fhir:code [ fhir:v "C49487" ] ;
fhir:display [ fhir:v "No" ]             ] )           ] )         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D005260" ] ;
fhir:display [ fhir:v "Female" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D005293" ] ;
fhir:display [ fhir:v "Ferritins" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
          ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Q000097" ] ;
fhir:display [ fhir:v "blood" ]           ] )         ] ) ;
        ( fhir:component [
fhir:type [
fhir:text [ fhir:v "is Major topic" ]           ] ;
          ( fhir:classifier [
            ( fhir:coding [
fhir:system [ fhir:v "https://ncithesaurus.nci.nih.gov/ncitbrowser"^^xsd:anyURI ] ;
fhir:code [ fhir:v "C49487" ] ;
fhir:display [ fhir:v "No" ]             ] )           ] )         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D006801" ] ;
fhir:display [ fhir:v "Humans" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D006973" ] ;
fhir:display [ fhir:v "Hypertension" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
          ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Q000150" ] ;
fhir:display [ fhir:v "complications" ]           ] )         ] ) ;
        ( fhir:component [
fhir:type [
fhir:text [ fhir:v "is Major topic" ]           ] ;
          ( fhir:classifier [
            ( fhir:coding [
fhir:system [ fhir:v "https://ncithesaurus.nci.nih.gov/ncitbrowser"^^xsd:anyURI ] ;
fhir:code [ fhir:v "C49487" ] ;
fhir:display [ fhir:v "No" ]             ] )           ] )         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D008297" ] ;
fhir:display [ fhir:v "Male" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D008875" ] ;
fhir:display [ fhir:v "Middle Aged" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D009767" ] ;
fhir:display [ fhir:v "Obesity, Morbid" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
          ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Q000150" ] ;
fhir:display [ fhir:v "complications" ]           ] )         ] ) ;
        ( fhir:component [
fhir:type [
fhir:text [ fhir:v "is Major topic" ]           ] ;
          ( fhir:classifier [
            ( fhir:coding [
fhir:system [ fhir:v "https://ncithesaurus.nci.nih.gov/ncitbrowser"^^xsd:anyURI ] ;
fhir:code [ fhir:v "C49488" ] ;
fhir:display [ fhir:v "Yes" ]             ] )           ] )         ] )       ] [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
          ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Q000188" ] ;
fhir:display [ fhir:v "drug therapy" ]           ] )         ] ) ;
        ( fhir:component [
fhir:type [
fhir:text [ fhir:v "is Major topic" ]           ] ;
          ( fhir:classifier [
            ( fhir:coding [
fhir:system [ fhir:v "https://ncithesaurus.nci.nih.gov/ncitbrowser"^^xsd:anyURI ] ;
fhir:code [ fhir:v "C49487" ] ;
fhir:display [ fhir:v "No" ]             ] )           ] )         ] )       ] [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
          ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Q000601" ] ;
fhir:display [ fhir:v "surgery" ]           ] )         ] ) ;
        ( fhir:component [
fhir:type [
fhir:text [ fhir:v "is Major topic" ]           ] ;
          ( fhir:classifier [
            ( fhir:coding [
fhir:system [ fhir:v "https://ncithesaurus.nci.nih.gov/ncitbrowser"^^xsd:anyURI ] ;
fhir:code [ fhir:v "C49487" ] ;
fhir:display [ fhir:v "No" ]             ] )           ] )         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D012074" ] ;
fhir:display [ fhir:v "Remission Induction" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] )     ] [
fhir:informationType [ fhir:v "classifier" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] ) ;
fhir:text [ fhir:v "components (if present) include qualifier codings" ]       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D016896" ] ;
fhir:display [ fhir:v "Treatment Outcome" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ) ;
fhir:freeToShare [ fhir:v "true"^^xsd:boolean ] ;
      ( fhir:component [
fhir:type [
fhir:text [ fhir:v "qualifier" ]         ] ;
        ( fhir:classifier [
fhir:text [ fhir:v "is not a major topic" ]         ] )       ] )     ] )
  ] [
a fhir:Practitioner ;
fhir:id [ fhir:v "contributor0" ] ;
    ( fhir:name [
fhir:family [ fhir:v "Jakobsen" ] ;
      ( fhir:given [ fhir:v "Gunn Signe" ] )     ] )
  ] [
a fhir:Practitioner ;
fhir:id [ fhir:v "contributor1" ] ;
    ( fhir:name [
fhir:family [ fhir:v "Småstuen" ] ;
      ( fhir:given [ fhir:v "Milada Cvancarova" ] )     ] )
  ] [
a fhir:Practitioner ;
fhir:id [ fhir:v "contributor2" ] ;
    ( fhir:name [
fhir:family [ fhir:v "Sandbu" ] ;
      ( fhir:given [ fhir:v "Rune" ] )     ] )
  ] [
a fhir:Practitioner ;
fhir:id [ fhir:v "contributor3" ] ;
    ( fhir:name [
fhir:family [ fhir:v "Nordstrand" ] ;
      ( fhir:given [ fhir:v "Njord" ] )     ] )
  ] [
a fhir:Practitioner ;
fhir:id [ fhir:v "contributor4" ] ;
    ( fhir:name [
fhir:family [ fhir:v "Hofsø" ] ;
      ( fhir:given [ fhir:v "Dag" ] )     ] )
  ] [
a fhir:Practitioner ;
fhir:id [ fhir:v "contributor5" ] ;
    ( fhir:name [
fhir:family [ fhir:v "Lindberg" ] ;
      ( fhir:given [ fhir:v "Morten" ] )     ] )
  ] [
a fhir:Practitioner ;
fhir:id [ fhir:v "contributor6" ] ;
    ( fhir:name [
fhir:family [ fhir:v "Hertel" ] ;
      ( fhir:given [ fhir:v "Jens Kristoffer" ] )     ] )
  ] [
a fhir:Practitioner ;
fhir:id [ fhir:v "contributor7" ] ;
    ( fhir:name [
fhir:family [ fhir:v "Hjelmesæth" ] ;
      ( fhir:given [ fhir:v "Jøran" ] )     ] )
  ] ) ; # 
  fhir:url [ fhir:v "https://fevir.net/resources/Citation/104116"^^xsd:anyURI] ; # 
  fhir:identifier ( [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "ACSN" ] ;
fhir:display [ fhir:v "Accession ID" ]       ] ) ;
fhir:text [ fhir:v "FEvIR Object Identifier" ]     ] ;
fhir:system [ fhir:v "https://fevir.net"^^xsd:anyURI ] ;
fhir:value [ fhir:v "104116" ] ;
fhir:assigner [
fhir:display [ fhir:v "Computable Publishing LLC" ]     ]
  ] [
fhir:system [ fhir:v "https://pubmed.ncbi.nlm.nih.gov"^^xsd:anyURI ] ;
fhir:value [ fhir:v "29340680" ] ;
fhir:assigner [
fhir:display [ fhir:v "NLM" ]     ]
  ] [
fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
fhir:value [ fhir:v "urn:oid:2.16.840.1.113883.4.642.40.44.15.38" ]
  ] ) ; # 
  fhir:version [ fhir:v "2.0.0-ballot"] ; # 
  fhir:title [ fhir:v "JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:date [ fhir:v "2022-09-06T14:07:55.073Z"^^xsd:dateTime] ; # 
  fhir:publisher [ fhir:v "HL7 International / Clinical Decision Support"] ; # 
  fhir:contact ( [
fhir:name [ fhir:v "HL7 International / Clinical Decision Support" ] ;
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/dss" ]     ] )
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fhir:name [ fhir:v "Brian S. Alper" ]
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fhir:text [ fhir:v "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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fhir:type [
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fhir:text [ fhir:v "**Importance:** The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain.\n**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.\n**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).\n**Exposures:** Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs.\n**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.\n**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 &lt; .001).\n**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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fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D005293" ] ;
fhir:display [ fhir:v "Ferritins" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] )     ] [
fhir:type [
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fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "publication-type" ] ;
fhir:display [ fhir:v "Publication type" ]         ] )       ] ;
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        ( fhir:coding [
fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D003160" ] ;
fhir:display [ fhir:v "Comparative Study" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] [
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fhir:system [ fhir:v "https://meshb.nlm.nih.gov/"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D016428" ] ;
fhir:display [ fhir:v "Journal Article" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] )     ] [
fhir:type [
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fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "citation-subset" ] ;
fhir:display [ fhir:v "Citation subset" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ;
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fhir:system [ fhir:v "https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#citationsubset"^^xsd:anyURI ] ;
fhir:code [ fhir:v "IM" ] ;
fhir:display [ fhir:v "IM" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] )     ] [
fhir:type [
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fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mesh-heading" ] ;
fhir:display [ fhir:v "MeSH heading" ]         ] )       ] ;
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fhir:reference [ fhir:v "#meshHeading0" ] ;
fhir:type [ fhir:v "ArtifactAssessment"^^xsd:anyURI ]       ] )     ] [
fhir:type [
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fhir:system [ fhir:v "http://hl7.org/fhir/cited-artifact-classification-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "knowledge-artifact-type" ] ;
fhir:display [ fhir:v "Knowledge Artifact Type" ] ;
fhir:userSelected [ fhir:v "false"^^xsd:boolean ]         ] )       ] ;
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fhir:system [ fhir:v "http://hl7.org/fhir/citation-artifact-classifier"^^xsd:anyURI ] ;
fhir:code [ fhir:v "D016428" ] ;
fhir:display [ fhir:v "Journal Article" ]         ] )       ] ) ;
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fhir:display [ fhir:v "Classifier added by Computable Publishing LLC" ]       ] )     ] ) ;
fhir:contributorship [
fhir:complete [ fhir:v "true"^^xsd:boolean ] ;
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fhir:contributor [
fhir:reference [ fhir:v "#contributor0" ] ;
fhir:type [ fhir:v "Practitioner"^^xsd:anyURI ] ;
fhir:display [ fhir:v "Jakobsen GS" ]         ] ;
fhir:forenameInitials [ fhir:v "GS" ] ;
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fhir:display [ fhir:v "Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway." ]         ] )       ] [
fhir:contributor [
fhir:reference [ fhir:v "#contributor1" ] ;
fhir:type [ fhir:v "Practitioner"^^xsd:anyURI ] ;
fhir:display [ fhir:v "Småstuen MC" ]         ] ;
fhir:forenameInitials [ fhir:v "MC" ] ;
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fhir:display [ fhir:v "Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway." ]         ] )       ] [
fhir:contributor [
fhir:reference [ fhir:v "#contributor2" ] ;
fhir:type [ fhir:v "Practitioner"^^xsd:anyURI ] ;
fhir:display [ fhir:v "Sandbu R" ]         ] ;
fhir:forenameInitials [ fhir:v "R" ] ;
        ( fhir:affiliation [
fhir:display [ fhir:v "Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway." ]         ] [
fhir:display [ fhir:v "Department of Surgery, Vestfold Hospital Trust, Tønsberg, Norway." ]         ] )       ] [
fhir:contributor [
fhir:reference [ fhir:v "#contributor3" ] ;
fhir:type [ fhir:v "Practitioner"^^xsd:anyURI ] ;
fhir:display [ fhir:v "Nordstrand N" ]         ] ;
fhir:forenameInitials [ fhir:v "N" ] ;
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fhir:display [ fhir:v "Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway." ]         ] )       ] [
fhir:contributor [
fhir:reference [ fhir:v "#contributor4" ] ;
fhir:type [ fhir:v "Practitioner"^^xsd:anyURI ] ;
fhir:display [ fhir:v "Hofsø D" ]         ] ;
fhir:forenameInitials [ fhir:v "D" ] ;
        ( fhir:affiliation [
fhir:display [ fhir:v "Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway." ]         ] )       ] [
fhir:contributor [
fhir:reference [ fhir:v "#contributor5" ] ;
fhir:type [ fhir:v "Practitioner"^^xsd:anyURI ] ;
fhir:display [ fhir:v "Lindberg M" ]         ] ;
fhir:forenameInitials [ fhir:v "M" ] ;
        ( fhir:affiliation [
fhir:display [ fhir:v "Department of Laboratory Medicine, Vestfold Hospital Trust, Tønsberg, Norway." ]         ] )       ] [
fhir:contributor [
fhir:reference [ fhir:v "#contributor6" ] ;
fhir:type [ fhir:v "Practitioner"^^xsd:anyURI ] ;
fhir:display [ fhir:v "Hertel JK" ]         ] ;
fhir:forenameInitials [ fhir:v "JK" ] ;
        ( fhir:affiliation [
fhir:display [ fhir:v "Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway." ]         ] )       ] [
fhir:contributor [
fhir:reference [ fhir:v "#contributor7" ] ;
fhir:type [ fhir:v "Practitioner"^^xsd:anyURI ] ;
fhir:display [ fhir:v "Hjelmesæth J" ]         ] ;
fhir:forenameInitials [ fhir:v "J" ] ;
        ( fhir:affiliation [
fhir:display [ fhir:v "Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway." ]         ] [
fhir:display [ fhir:v "Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway." ]         ] )       ] )     ]
  ] . #