{"certainty":[{"description":"Very low certainty due to risk of bias, inconsistency, imprecision, and indirectness","rating":{"coding":[{"code":"very-low","display":"Very low quality","system":"http://terminology.hl7.org/CodeSystem/certainty-rating"}]},"subcomponent":[{"rating":{"coding":[{"code":"no-concern","display":"no serious concern","system":"http://terminology.hl7.org/CodeSystem/certainty-rating"}]},"type":{"coding":[{"code":"PublicationBias","display":"Publication bias","system":"http://terminology.hl7.org/CodeSystem/certainty-type"}]}},{"note":[{"text":"IST-3 had inconsistent results and contributed large proportion of data"}],"rating":{"coding":[{"code":"serious-concern","display":"serious concern","system":"http://terminology.hl7.org/CodeSystem/certainty-rating"}]},"type":{"coding":[{"code":"Inconsistency","display":"Inconsistency","system":"http://terminology.hl7.org/CodeSystem/certainty-type"}]}},{"note":[{"text":"results derived from figure with limited data reported to support the specific effect estimate; derived odds ratio in figure does not match results from rates of mRS 0-2 reported in Supplementary Figure 3b"}],"rating":{"coding":[{"code":"serious-concern","display":"serious concern","system":"http://terminology.hl7.org/CodeSystem/certainty-rating"}]},"type":{"coding":[{"code":"Imprecision","display":"Imprecision","system":"http://terminology.hl7.org/CodeSystem/certainty-type"}]}},{"note":[{"text":"resuts derived for 3 - 4.5 hours assume data from 0 - 6 hours is informative"}],"rating":{"coding":[{"code":"serious-concern","display":"serious concern","system":"http://terminology.hl7.org/CodeSystem/certainty-rating"}]},"type":{"coding":[{"code":"Indirectness","display":"Indirectness","system":"http://terminology.hl7.org/CodeSystem/certainty-type"}]}},{"note":[{"text":"results largely influenced by IST-3 trial which was unblinded and ECASS III which had baseline imbalances"}],"rating":{"coding":[{"code":"serious-concern","display":"serious concern","system":"http://terminology.hl7.org/CodeSystem/certainty-rating"}]},"type":{"coding":[{"code":"RiskOfBias","display":"Risk of bias","system":"http://terminology.hl7.org/CodeSystem/certainty-type"}]}}],"type":{"coding":[{"code":"Overall","display":"Overall certainty","system":"http://terminology.hl7.org/CodeSystem/certainty-type"}]}}],"contact":[{"telecom":[{"system":"url","value":"http://www.hl7.org/Special/committees/dss"}]}],"description":"mRS 0-2 at 90 days Odds Ratio 1.2 for Alteplase vs. No Alteplase in patients with acute ischemic stroke 3-4.5 hours prior","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-wg","valueCode":"cds"}],"id":"example-stroke-3-4half-alteplase-vs-no-alteplase-mRS0-2","identifier":[{"system":"urn:ietf:rfc:3986","value":"urn:oid:2.16.840.1.113883.4.642.10.3"}],"name":"EffectOfAlteplaseVsNoAlteplaseOnMRS02At90DaysInStroke345HoursPrior","publisher":"HL7 International / Clinical Decision Support","relatesTo":[{"targetMarkdown":"Figure 2 Lees 2016 <b>Citation:</b> Lees KR, Emberson J, Blackwell L, Bluhmki E, Davis SM, Donnan GA, et al; Stroke Thrombolysis Trialists’ Collaborators Group. Effects of alteplase for acute stroke on the distribution of functional outcomes: a pooled analysis of 9 trials. Stroke. 2016;47:2373-2379. PMID 27507856 <b>URL:</b> https://doi.org/10.1161/STROKEAHA.116.013644","type":{"coding":[{"code":"cites","display":"Cites","system":"http://terminology.hl7.org/CodeSystem/artifact-relationship-type"}]}}],"resourceType":"Evidence","statistic":[{"attributeEstimate":[{"description":"95% CI 1.06 to 1.3","level":0.95,"range":{"high":{"value":1.3},"low":{"value":1.06}},"type":{"coding":[{"code":"C53324","display":"Confidence interval","system":"http://terminology.hl7.org/CodeSystem/attribute-estimate-type"}]}}],"quantity":{"value":1.2},"sampleSize":{"numberOfStudies":9},"statisticType":{"coding":[{"code":"STATO:0000182","display":"odds ratio","system":"https://fevir.net/sevco"}]}}],"status":"draft","studyDesign":[{"coding":[{"code":"SEVCO:01003","display":"randomized assignment","system":"https://fevir.net/sevco"}]}],"synthesisType":[{"coding":[{"code":"IPD-MA","display":"individual patient data meta-analysis","system":"http://terminology.hl7.org/CodeSystem/synthesis-type"}]}],"text":{"div":"<div xmlns=\"http://www.w3.org/1999/xhtml\">\n      \n      <p>\n        \"Effect of Alteplase vs No alteplase on mRS 0-2 at 90 days in Stroke 3-4.5 hours prior\" is a comparative effect estimate.\n      </p>\n\t\n    </div>","status":"generated"},"title":"Effect of Alteplase vs No alteplase on mRS 0-2 at 90 days in Stroke 3-4.5 hours prior","url":"http://hl7.org/fhir/Evidence/example-stroke-3-4half-alteplase-vs-no-alteplase-mRS0-2","variableDefinition":[{"directnessMatch":{"coding":[{"code":"moderate","display":"Moderate quality match between observed and intended variable","system":"http://terminology.hl7.org/CodeSystem/directness"}]},"intended":{"display":"stroke at 3-4.5 hours","reference":"Group/AcuteIschemicStroke3-4halfHours","type":"Group"},"observed":{"display":"Stroke Thrombolysis Trialists’ 2014-2016 IPD-MA Cohort","reference":"EvidenceVariable/Stroke-Thrombolysis-Trialists-2014-2016-IPD-MA-Cohort","type":"EvidenceVariable"},"variableRole":"population"},{"intended":{"display":"Alive and not functionally dependent at 90 days","reference":"EvidenceVariable/example-alive-independent-90day","type":"EvidenceVariable"},"observed":{"display":"mRS 0-2 at 90 days","reference":"EvidenceVariable/example-mRS0-2-at-90days","type":"EvidenceVariable"},"variableRole":"outcome"},{"comparatorCategory":"No Alteplase","observed":{"display":"Group Assignment: Alteplase for Stroke vs No Alteplase","reference":"EvidenceVariable/example-group-assignment-alteplase-for-stroke-vs-no-alteplase","type":"EvidenceVariable"},"variableRole":"exposure"}]}