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

: ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study - XML Representation

Active as of 2022-09-19

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    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Evidence 104121</b></p><a name="104121"> </a><a name="hc104121"> </a><a name="104121-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: 12; Last updated: 2023-12-06 00:53:26+0000</p><p style="margin-bottom: 0px">Profiles: <a href="StructureDefinition-comparative-evidence.html">ComparativeEvidence</a>, <a href="StructureDefinition-single-study-evidence.html">SingleStudyEvidence</a></p></div><p><b>url</b>: <a href="Evidence-104121.html">Evidence ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study</a></p><p><b>identifier</b>: FEvIR Object Identifier/104121, <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 

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Note 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.

This OID may also be used in CD.codeSystem.">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.4.642.40.44.22.12</p><p><b>version</b>: 2.0.0-ballot</p><p><b>name</b>: ComparativeEvidence_Bypass_surgery_effects_on_Remission_of_diabetes_in_JAMA_2018_Norwegian_cohort_study</p><p><b>title</b>: ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study</p><p><b>status</b>: Active</p><p><b>date</b>: 2022-09-19 21:16:23+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>author</b>: Brian S. Alper: </p><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="CodeSystem-179423.html#179423-evidence-communication">Evidence Based Medicine on FHIR Implementation Guide Code System evidence-communication</a>: Evidence Communication</td><td><span title="Codes:{https://fevir.net/resources/CodeSystem/179423 ComparativeEvidence}">ComparativeEvidence</span></td></tr><tr><td style="display: none">*</td><td><a href="CodeSystem-179423.html#179423-evidence-communication">Evidence Based Medicine on FHIR Implementation Guide Code System evidence-communication</a>: Evidence Communication</td><td><span title="Codes:{https://fevir.net/resources/CodeSystem/179423 SingleStudyEvidence}">SingleStudyEvidence</span></td></tr></table><p><b>copyright</b>: </p><div><p>https://creativecommons.org/licenses/by-nc-sa/4.0/</p>
</div><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: Derived From</p><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://jamanetwork.com/journals/jama/fullarticle/2669729">https://jamanetwork.com/journals/jama/fullarticle/2669729</a></td></tr></table></blockquote><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: Cite As</p><p><b>citation</b>: </p><div><p>ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study [Evidence]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 104121. Revised 2022-09-19. Available at: https://fevir.net/resources/Evidence/104121. Computable resource at: https://fevir.net/resources/Evidence/104121.</p>
</div></blockquote><p><b>description</b>: </p><div><p>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]</p>
</div><p><b>assertion</b>: </p><div><p>Compared with specialized medical treatment, bariatric surgery appears to induce remission of diabetes.</p>
</div><blockquote><p><b>variableDefinition</b></p><p><b>org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code</b>: population</p><p><b>description</b>: </p><div><p>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).</p>
</div><p><b>note</b>: population</p><p><b>observed</b>: <a href="Group-178427.html">StudyGroup: Severely Obese Adults 2018 Norwegian Cohort</a></p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code</b>: exposure</p><p><b>org/fhir/uv/ebm/StructureDefinition/variable-definition-comparator-category</b>: no bariatric surgery</p><p><b>description</b>: </p><div><p>bariatric surgery vs. specialized medical treatment without bariatric surgery</p>
</div><p><b>note</b>: exposure</p><p><b>intended</b>: <a href="EvidenceVariable-172427.html">GroupAssignment: Bariatric Surgery vs. no bariatric surgery</a></p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code</b>: outcome</p><p><b>description</b>: </p><div><p>Remission of diabetes</p>
</div><p><b>note</b>: outcome</p><p><b>observed</b>: <a href="EvidenceVariable-104117.html">OutcomeVariable: Remission of diabetes</a></p></blockquote><p><b>synthesisType</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/synthesis-type NotApplicable}">not applicable</span></p><p><b>studyDesign</b>: <span title="Codes:{http://hl7.org/fhir/study-design SEVCO:01002}">Observational research</span>, <span title="Codes:{http://hl7.org/fhir/study-design SEVCO:01011}">Parallel cohort design</span>, <span title="Codes:{http://hl7.org/fhir/study-design SEVCO:01028}">Longitudinal data collection</span></p><blockquote><p><b>statistic</b></p><p><b>description</b>: </p><div><p>Relative risk 3.9; 95% CI 2.8 to 5.4</p>
</div><p><b>note</b>: Result observed without bariatric surgery was 14.8%, result observed with bariatric surgery was 57.5%</p><p><b>statisticType</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/statistic-type C93152}">Relative Risk</span></p><p><b>quantity</b>: 3.9</p><h3>SampleSizes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>NumberOfStudies</b></td><td><b>NumberOfParticipants</b></td><td><b>KnownDataCount</b></td></tr><tr><td style="display: none">*</td><td>1</td><td>1888</td><td>1888</td></tr></table><h3>AttributeEstimates</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Description</b></td><td><b>Type</b></td><td><b>Level</b></td><td><b>Range</b></td></tr><tr><td style="display: none">*</td><td><div><p>95% CI 2.8 to 5.4</p>
</div></td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/attribute-estimate-type C53324}">Confidence interval</span></td><td>0.95</td><td>2.8-5.4</td></tr></table></blockquote><h3>Certainties</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Description</b></td><td><b>Type</b></td><td><b>Rating</b></td></tr><tr><td style="display: none">*</td><td><div><p>rated down 2 levels due to observational study, rated up 1 level due to large effect size</p>
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