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