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

: ComparativeEvidence: Bypass surgery effects on New onset depression in JAMA 2018 Norwegian cohort study - JSON Representation

Active as of 2022-09-19

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{
  "resourceType" : "Evidence",
  "id" : "104155",
  "meta" : {
    "versionId" : "11",
    "lastUpdated" : "2023-12-06T00:52:24.675Z",
    "profile" : [
      🔗 "http://hl7.org/fhir/uv/ebm/StructureDefinition/comparative-evidence"🔗 ,
      "http://hl7.org/fhir/uv/ebm/StructureDefinition/single-study-evidence"
    ]
  },
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    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Evidence</b><a name=\"104155\"> </a><a name=\"hc104155\"> </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\">ResourceEvidence &quot;104155&quot; Version &quot;11&quot; Updated &quot;2023-12-06 00:52:24+0000&quot; </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>: <code>https://fevir.net/resources/Evidence/104155</code></p><p><b>identifier</b>: FEvIR Object Identifier/104155</p><p><b>version</b>: 1.0.0-ballot</p><p><b>name</b>: ComparativeEvidence_Bypass_surgery_effects_on_New_onset_depression_in_JAMA_2018_Norwegian_cohort_study</p><p><b>title</b>: ComparativeEvidence: Bypass surgery effects on New onset depression in JAMA 2018 Norwegian cohort study</p><p><b>status</b>: active</p><p><b>date</b>: 2022-09-19 21:16:07+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>Evidence Communication (Details: Evidence Based Medicine on FHIR Implementation Guide Code System code evidence-communication = 'Evidence Communication', stated as 'Evidence Communication')</td><td>ComparativeEvidence <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>#ComparativeEvidence)</span></td></tr><tr><td style=\"display: none\">*</td><td>Evidence Communication (Details: Evidence Based Medicine on FHIR Implementation Guide Code System code evidence-communication = 'Evidence Communication', stated as 'Evidence Communication')</td><td>SingleStudyEvidence <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>#SingleStudyEvidence)</span></td></tr></table><p><b>copyright</b>: https://creativecommons.org/licenses/by-nc-sa/4.0/</p><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: derived-from</p><blockquote><p><b>document</b></p></blockquote></blockquote><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: cite-as</p><p><b>citation</b>: ComparativeEvidence: Bypass surgery effects on New onset depression in JAMA 2018 Norwegian cohort study [Evidence]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 104155. Revised 2022-09-19. Available at: https://fevir.net/resources/Evidence/104155. Computable resource at: https://fevir.net/resources/Evidence/104155.</p></blockquote><p><b>description</b>: 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]</p><p><b>assertion</b>: Compared with specialized medical treatment, bariatric surgery may slightly increase the incidence of depression.</p><blockquote><p><b>variableDefinition</b></p><p><b>VariableDefinitionVariableRoleCode</b>: population</p><p><b>description</b>: 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\u2009=\u20092109) with severe obesity assessed (221 patients excluded and 1888 patients included).</p><p><b>note</b>: population</p><p><b>variableRole</b>: Use extension:variableRoleCode instead. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-variable-role.html\">EvidenceVariableRole</a>#population &quot;population&quot;)</span></p><p><b>observed</b>: <a href=\"Group-178427.html\">Group/178427: StudyGroup: Severely Obese Adults 2018 Norwegian Cohort</a> &quot;Severely_Obese_Adults_2018_Norwegian_Cohort&quot;</p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>VariableDefinitionVariableRoleCode</b>: exposure</p><p><b>VariableDefinitionComparatorCategory</b>: no bariatric surgery</p><p><b>description</b>: bariatric surgery vs. specialized medical treatment without bariatric surgery</p><p><b>note</b>: exposure</p><p><b>variableRole</b>: Use extension:variableRoleCode instead. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-variable-role.html\">EvidenceVariableRole</a>#exposure &quot;exposure&quot;)</span></p><p><b>observed</b>: <a href=\"EvidenceVariable-172427.html\">EvidenceVariable/172427: GroupAssignment: Bariatric Surgery vs. no bariatric surgery</a> &quot;GroupAssignment_Bariatric_Surgery_vs_no_bariatric_surgery&quot;</p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>VariableDefinitionVariableRoleCode</b>: outcome</p><p><b>description</b>: New onset depression</p><p><b>note</b>: outcome</p><p><b>variableRole</b>: Use extension:variableRoleCode instead. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-variable-role.html\">EvidenceVariableRole</a>#measuredVariable &quot;measured variable&quot;)</span></p><p><b>observed</b>: <a href=\"EvidenceVariable-104118.html\">EvidenceVariable/104118: OutcomeVariable: New onset depression</a> &quot;OutcomeVariable_New_onset_depression&quot;</p></blockquote><p><b>synthesisType</b>: not applicable <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-synthesis-type.html\">StatisticSynthesisType</a>#NotApplicable)</span></p><p><b>studyDesign</b>: Observational research <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-study-design.html\">Study Design</a>#SEVCO:01002)</span>, Parallel cohort design <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-study-design.html\">Study Design</a>#SEVCO:01011)</span>, Longitudinal data collection <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-study-design.html\">Study Design</a>#SEVCO:01028)</span></p><blockquote><p><b>statistic</b></p><p><b>description</b>: Relative risk 1.5; 95% CI 1.4 to 1.7</p><p><b>note</b>: Result observed without bariatric surgery was 6.5%, result observed with bariatric surgery was 8.9%</p><p><b>statisticType</b>: Relative Risk <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-statistic-type.html\">StatisticStatisticType</a>#C93152)</span></p><p><b>quantity</b>: 1.5</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>95% CI 1.4 to 1.7</td><td>Confidence interval <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-attribute-estimate-type.html\">StatisticAttribute Estimate Type</a>#C53324)</span></td><td>0.95</td><td>1.4-1.7</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>rated down 2 levels due to observational study</td><td>Overall certainty <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R5/codesystem-certainty-type.html\">Evidence Certainty Type</a>#Overall)</span></td><td>Low quality <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-certainty-rating.html\">StatisticCertaintyRating</a>#low)</span></td></tr></table></div>"
  },
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  "version" : "1.0.0-ballot",
  "name" : "ComparativeEvidence_Bypass_surgery_effects_on_New_onset_depression_in_JAMA_2018_Norwegian_cohort_study",
  "title" : "ComparativeEvidence: Bypass surgery effects on New onset depression in JAMA 2018 Norwegian cohort study",
  "status" : "active",
  "date" : "2022-09-19T21:16:07.557Z",
  "publisher" : "HL7 International / Clinical Decision Support",
  "contact" : [
    {
      "name" : "HL7 International / Clinical Decision Support",
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  "useContext" : [
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  "relatedArtifact" : [
    {
      "type" : "derived-from",
      "document" : {
        "url" : "https://jamanetwork.com/journals/jama/fullarticle/2669729"
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    },
    {
      "type" : "cite-as",
      "citation" : "ComparativeEvidence: Bypass surgery effects on New onset depression in JAMA 2018 Norwegian cohort study [Evidence]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 104155. Revised 2022-09-19. Available at: https://fevir.net/resources/Evidence/104155. Computable resource at: https://fevir.net/resources/Evidence/104155."
    }
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  "description" : "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]",
  "assertion" : "Compared with specialized medical treatment, bariatric surgery may slightly increase the incidence of depression.",
  "variableDefinition" : [
    {
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          "url" : "http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code",
          "valueCode" : "population"
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      ],
      "description" : "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\u2009=\u20092109) with severe obesity assessed (221 patients excluded and 1888 patients included).",
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        "text" : "Use extension:variableRoleCode instead."
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      "observed" : {
        🔗 "reference" : "Group/178427",
        "type" : "Group",
        "display" : "StudyGroup: Severely Obese Adults 2018 Norwegian Cohort"
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    {
      "extension" : [
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      "description" : "bariatric surgery vs. specialized medical treatment without bariatric surgery",
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            "code" : "exposure",
            "display" : "exposure"
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        "text" : "Use extension:variableRoleCode instead."
      },
      "observed" : {
        🔗 "reference" : "EvidenceVariable/172427",
        "type" : "EvidenceVariable",
        "display" : "GroupAssignment: Bariatric Surgery vs. no bariatric surgery"
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    {
      "extension" : [
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      "description" : "New onset depression",
      "note" : [
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            "code" : "measuredVariable",
            "display" : "measured variable"
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        "text" : "Use extension:variableRoleCode instead."
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      "observed" : {
        🔗 "reference" : "EvidenceVariable/104118",
        "type" : "EvidenceVariable",
        "display" : "OutcomeVariable: New onset depression"
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  "studyDesign" : [
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  "statistic" : [
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      "description" : "Relative risk 1.5; 95% CI 1.4 to 1.7",
      "note" : [
        {
          "text" : "Result observed without bariatric surgery was 6.5%, result observed with bariatric surgery was 8.9%"
        }
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      "statisticType" : {
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      "quantity" : {
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      "sampleSize" : {
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        "numberOfParticipants" : 1888,
        "knownDataCount" : 1888
      },
      "attributeEstimate" : [
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          "type" : {
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            "high" : {
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  "certainty" : [
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      "type" : {
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}