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

: Certainty of Evidence Rating of 14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY) - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:ArtifactAssessment ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "179693"] ; # 
  fhir:meta [
fhir:versionId [ fhir:v "7" ] ;
fhir:lastUpdated [ fhir:v "2024-12-12T13:06:16.440Z"^^xsd:dateTime ] ;
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/uv/ebm/StructureDefinition/certainty-of-evidence"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/uv/ebm/StructureDefinition/certainty-of-evidence>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ArtifactAssessment 179693</b></p><a name=\"179693\"> </a><a name=\"hc179693\"> </a><a name=\"179693-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: 7; Last updated: 2024-12-12 13:06:16+0000</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-certainty-of-evidence.html\">CertaintyOfEvidence</a></p></div><p><b>Artifact URL</b>: <a href=\"https://fevir.net/resources/ArtifactAssessment/179693\">https://fevir.net/resources/ArtifactAssessment/179693</a></p><p><b>Artifact Description</b>: </p><div><p>This example of a CertaintyOfEvidence Profile shows a recursive pattern of component elements with type/classifier paired values for different aspects of rating the certainty of evidence.</p>\n</div><p><b>identifier</b>: FEvIR Object Identifier/https://fevir.net/FOI/179693</p><p><b>title</b>: Certainty of Evidence Rating of 14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)</p><p><b>artifact</b>: <a href=\"Evidence-55.html\">14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)</a></p><blockquote><p><b>content</b></p><p><b>summary</b>: </p><div><p>Low certainty due to inconsistency and risk of bias</p>\n</div><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-type Overall}\">Overall certainty</span></p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-rating low}\">Low quality</span></p><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-type PublicationBias}\">Publication bias</span></p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-rating no-concern}\">no serious concern</span></p></blockquote><blockquote><p><b>component</b></p><p><b>summary</b>: </p><div><p>There is a high degree of heterogeneity (I-squared = 73%). There is also inconsistency in findings between the fixed-effect and random-effects statistical models.</p>\n</div><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-type Inconsistency}\">Inconsistency</span></p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-rating serious-concern}\">serious concern</span></p></blockquote><blockquote><p><b>component</b></p><p><b>summary</b>: </p><div><p>Although the random-effects analysis finds an estimate without statistical significance, this imprecision is explained by the inconsistency (heterogeneity) and thus not further downrated in certainty assessment.</p>\n</div><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-type Imprecision}\">Imprecision</span></p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-rating no-concern}\">no serious concern</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-type Indirectness}\">Indirectness</span></p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-rating no-concern}\">no serious concern</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-type RiskOfBias}\">Risk of bias</span></p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-rating serious-concern}\">serious concern</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Summary</b></td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><div><p>No blinding (no placebo control) in the largest trial</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/181513 SEVCO:00035}\">Lack of blinding</span></td><td><span title=\"Codes:{http://hl7.org/fhir/certainty-rating present}\">present</span></td></tr></table></blockquote></blockquote></div>"
  ] ; # 
  fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/artifact-url"^^xsd:anyURI ] ;
fhir:value [ fhir:v "https://fevir.net/resources/ArtifactAssessment/179693"^^xsd:anyURI ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/artifact-description"^^xsd:anyURI ] ;
fhir:value [ fhir:v "This example of a CertaintyOfEvidence Profile shows a recursive pattern of component elements with type/classifier paired values for different aspects of rating the certainty of evidence." ]
  ] ) ; # 
  fhir:identifier ( [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "ACSN" ] ;
fhir:display [ fhir:v "Accession ID" ]       ] ) ;
fhir:text [ fhir:v "FEvIR Object Identifier" ]     ] ;
fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
fhir:value [ fhir:v "https://fevir.net/FOI/179693" ] ;
fhir:assigner [
fhir:display [ fhir:v "Computable Publishing LLC" ]     ]
  ] ) ; # 
  fhir:title [ fhir:v "Certainty of Evidence Rating of 14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)"] ; # 
  fhir:artifact [
a fhir:Reference ;
fhir:reference [ fhir:v "Evidence/55" ] ;
fhir:type [ fhir:v "Evidence"^^xsd:anyURI ] ;
fhir:display [ fhir:v "14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)" ]
  ] ; # 
  fhir:content ( [
fhir:summary [ fhir:v "Low certainty due to inconsistency and risk of bias" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/certainty-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Overall" ] ;
fhir:display [ fhir:v "Overall certainty" ]       ] )     ] ;
    ( fhir:classifier [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/certainty-rating"^^xsd:anyURI ] ;
fhir:code [ fhir:v "low" ] ;
fhir:display [ fhir:v "Low quality" ]       ] )     ] ) ;
    ( fhir:component [
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/certainty-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "PublicationBias" ] ;
fhir:display [ fhir:v "Publication bias" ]         ] )       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/certainty-rating"^^xsd:anyURI ] ;
fhir:code [ fhir:v "no-concern" ] ;
fhir:display [ fhir:v "no serious concern" ]         ] )       ] )     ] [
fhir:summary [ fhir:v "There is a high degree of heterogeneity (I-squared = 73%). There is also inconsistency in findings between the fixed-effect and random-effects statistical models." ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/certainty-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Inconsistency" ] ;
fhir:display [ fhir:v "Inconsistency" ]         ] )       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/certainty-rating"^^xsd:anyURI ] ;
fhir:code [ fhir:v "serious-concern" ] ;
fhir:display [ fhir:v "serious concern" ]         ] )       ] )     ] [
fhir:summary [ fhir:v "Although the random-effects analysis finds an estimate without statistical significance, this imprecision is explained by the inconsistency (heterogeneity) and thus not further downrated in certainty assessment." ] ;
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/certainty-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Imprecision" ] ;
fhir:display [ fhir:v "Imprecision" ]         ] )       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/certainty-rating"^^xsd:anyURI ] ;
fhir:code [ fhir:v "no-concern" ] ;
fhir:display [ fhir:v "no serious concern" ]         ] )       ] )     ] [
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/certainty-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Indirectness" ] ;
fhir:display [ fhir:v "Indirectness" ]         ] )       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/certainty-rating"^^xsd:anyURI ] ;
fhir:code [ fhir:v "no-concern" ] ;
fhir:display [ fhir:v "no serious concern" ]         ] )       ] )     ] [
fhir:type [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/certainty-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "RiskOfBias" ] ;
fhir:display [ fhir:v "Risk of bias" ]         ] )       ] ;
      ( fhir:classifier [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/certainty-rating"^^xsd:anyURI ] ;
fhir:code [ fhir:v "serious-concern" ] ;
fhir:display [ fhir:v "serious concern" ]         ] )       ] ) ;
      ( fhir:component [
fhir:summary [ fhir:v "No blinding (no placebo control) in the largest trial" ] ;
fhir:type [
          ( fhir:coding [
fhir:system [ fhir:v "https://fevir.net/resources/CodeSystem/181513"^^xsd:anyURI ] ;
fhir:code [ fhir:v "SEVCO:00035" ] ;
fhir:display [ fhir:v "Inadequate blinding of participants" ]           ] ) ;
fhir:text [ fhir:v "Lack of blinding" ]         ] ;
        ( fhir:classifier [
          ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/certainty-rating"^^xsd:anyURI ] ;
fhir:code [ fhir:v "present" ] ;
fhir:display [ fhir:v "present" ]           ] )         ] )       ] )     ] )
  ] ) . #