<?xml version="1.0" encoding="UTF-8"?><ArtifactAssessment xmlns="http://hl7.org/fhir">
  <id value="example-certainty-rating"/>
  <meta>
    <security>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
      <code value="HTEST"/>
      <display value="test health data"/>
    </security>
  </meta>
  <identifier>
    <type>
      <text value="FEvIR Object Identifier"/>
    </type>
    <system value="https://fevir.net"/>
    <value value="27756"/>
    <assigner>
      <display value="Computable Publishing LLC"/>
    </assigner>
  </identifier>
  <artifactReference>
    <reference value="Evidence/example-stroke-alteplase-fatalICH"/>
    <type value="Evidence"/>
    <display value="Critically appraised summary of all-cause mortality in meta-analysis of RCTs of heparin for moderately ill patients with COVID-19"/>
  </artifactReference>
  <date value="2021-11-02T14:48:59.890Z"/>
  <copyright value="https://creativecommons.org/licenses/by-nc-sa/4.0/"/>
  <content>
    <summary value="serious concerns with risk of bias, inconsistency, and imprecision"/>
    <type>
      <coding>
        <system value="http://hl7.org/fhir/certainty-type"/>
        <code value="Overall"/>
        <display value="Overall certainty"/>
      </coding>
    </type>
    <classifier>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
        <code value="very-low"/>
        <display value="Very low quality"/>
      </coding>
    </classifier>
    <author>
      <display value="Brian S. Alper"/>
    </author>
    <freeToShare value="true"/>
    <component>
      <summary value="risk of bias in both included trials"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/certainty-type"/>
          <code value="RiskOfBias"/>
          <display value="Risk of bias"/>
        </coding>
      </type>
      <classifier>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
          <code value="serious-concern"/>
          <display value="serious concern"/>
        </coding>
      </classifier>
      <author>
        <display value="Brian S. Alper"/>
      </author>
    </component>
    <component>
      <summary value="high degree of heterogeneity (I-squared 80.7%) with confidence intervals of 2 trial effect estimates barely overlapping"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/certainty-type"/>
          <code value="Inconsistency"/>
          <display value="Inconsistency"/>
        </coding>
      </type>
      <classifier>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
          <code value="serious-concern"/>
          <display value="serious concern"/>
        </coding>
      </classifier>
      <author>
        <display value="Brian S. Alper"/>
      </author>
    </component>
    <component>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/certainty-type"/>
          <code value="Indirectness"/>
          <display value="Indirectness"/>
        </coding>
      </type>
      <classifier>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
          <code value="no-concern"/>
          <display value="no serious concern"/>
        </coding>
      </classifier>
      <author>
        <display value="Brian S. Alper"/>
      </author>
    </component>
    <component>
      <summary value="95% confidence interval includes both large effects and no effects"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/certainty-type"/>
          <code value="Imprecision"/>
          <display value="Imprecision"/>
        </coding>
      </type>
      <classifier>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
          <code value="serious-concern"/>
          <display value="serious concern"/>
        </coding>
      </classifier>
      <author>
        <display value="Brian S. Alper"/>
      </author>
    </component>
    <component>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/certainty-type"/>
          <code value="PublicationBias"/>
          <display value="Publication bias"/>
        </coding>
      </type>
      <classifier>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
          <code value="no-concern"/>
          <display value="no serious concern"/>
        </coding>
      </classifier>
      <author>
        <display value="Brian S. Alper"/>
      </author>
    </component>
  </content>
</ArtifactAssessment>