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

: Recommendation: ADA Obesity Management Recommendation 8.17 - XML Representation

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    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Composition</b><a name="179467"> </a><a name="hc179467"> </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">ResourceComposition &quot;179467&quot; Version &quot;5&quot; Updated &quot;2024-04-27 18:00:53+0000&quot; </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-recommendation.html">Recommendation</a></p></div><p><b>Artifact Description</b>: Example of Recommendation Profile of Composition Resource.</p><p><b>url</b>: <a href="https://fevir.net/resources/Composition/179467">https://fevir.net/resources/Composition/179467</a></p><p><b>identifier</b>: FEvIR Object Identifier/179467</p><p><b>status</b>: final</p><p><b>type</b>: EvidenceReport <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>#EvidenceReport)</span></p><p><b>category</b>: Recommendation <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)</span></p><p><b>date</b>: 2024-04-27 18:00:53+0000</p><p><b>author</b>: <span>: Brian S. Alper</span></p><p><b>title</b>: Recommendation: ADA Obesity Management Recommendation 8.17</p><p><b>custodian</b>: <a href="Organization-118079.html">Organization/118079: Computable Publishing LLC</a> &quot;Computable_Publishing_LLC&quot;</p><h3>RelatesTos</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>cite-as</td><td> </td><td>Recommendation: ADA Obesity Management Recommendation 8.17 [Composition]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 179467. Revised 2023-11-24. Available at: https://fevir.net/resources/Composition/179467. Computable resource at: https://fevir.net/resources/Composition/179467.</td><td> </td></tr><tr><td style="display: none">*</td><td>derived-from</td><td>PlanDefinition <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td> </td><td><a href="PlanDefinition-179554.html">PlanDefinition/179554: PlanDefinition for Recommendation: ADA Obesity Management Recommendation 8.17</a></td></tr><tr><td style="display: none">*</td><td>derived-from</td><td>RecommendationJustification <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td> </td><td><a href="ArtifactAssessment-179515.html">ArtifactAssessment/179515: Justification for Recommendation: ADA Obesity Management Recommendation 8.17</a></td></tr></table></div>
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        <div xmlns="http://www.w3.org/1999/xhtml">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</div>
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        <div xmlns="http://www.w3.org/1999/xhtml">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.</div>
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        <div xmlns="http://www.w3.org/1999/xhtml">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.</div>
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        <div xmlns="http://www.w3.org/1999/xhtml">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.</div>
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        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml">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</div>
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