Comparison: Original and Adapted Recommendation: ADA Obesity Management Recommendation 8.16 - Evidence Based Medicine on FHIR Implementation Guide v2.0.0-ballot

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

Example ArtifactAssessment: Comparison: Original and Adapted Recommendation: ADA Obesity Management Recommendation 8.16

Generated Narrative: ArtifactAssessment 179700

version: 5; Last updated: 2023-12-06 14:24:23+0000

Profile: Comparison

ArtifactAssessmentCompared: Recommendation: ADA Obesity Management Recommendation 8.16-adapted

Artifact URL: https://fevir.net/resources/ArtifactAssessment/179700

Artifact Description:

This Comparison Profile shows a comparison of top-level elements between two Resources and classifies each element pairing as Same or Different based on whether the content is a match.

identifier: FEvIR Object Identifier/179700

title: Comparison: Original and Adapted Recommendation: ADA Obesity Management Recommendation 8.16

citeAs:

Comparison: Original and Adapted Recommendation: ADA Obesity Management Recommendation 8.16 [ArtifactAssessment]. Contributors: In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 179700. Revised 2023-11-28. Available at: https://fevir.net/resources/ArtifactAssessment/179700. Computable resource at: https://fevir.net/resources/ArtifactAssessment/179700.

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[[2]] Diagnosed with type 2 diabetes. [[3]] Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods. 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These disclosures are discussed at the outset of each Standards of Care revision meeting. Members of the committee, their employers, and their disclosed conflicts of interest are listed in 'Disclosures: Standards of Medical Care in Diabetes—2021' (https://doi.org/10.2337/dc21-SPPC). The ADA funds development of the Standards of Care out of its general revenues and does not use industry support for this purpose. NOTE: The disclosed conflicts of interest was not found at the suggested URL"},"entry":[{"reference":"ArtifactAssessment/179469","type":"ArtifactAssessment"}],"section":[{"title":"Competing Interests Ratings","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"ratings","display":"Ratings"}],"text":"competingInterestsRatings"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Competing Interests Related Items","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"related-items","display":"Related Items"}],"text":"competingInterestsRelatedItems"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}}]},{"title":"Research Priorities Summary","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"research-considerations","display":"Research Considerations"}],"text":"researchConsiderationsSummary"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]},"section":[{"title":"Research Priorities Ratings","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"ratings","display":"Ratings"}],"text":"researchConsiderationsRatings"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Research Priorities Related Items","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"related-items","display":"Related Items"}],"text":"researchConsiderationsRelatedItems"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}}]}]}]

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"},"entry":[{"reference":"ArtifactAssessment/179469","type":"ArtifactAssessment"}]},{"title":"Recommendation Rating System","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"rating-system","display":"Rating System"}]},"text":{"status":"generated","div":"ADA Level of Evidence"},"entry":[{"reference":"ArtifactAssessment/179469","type":"ArtifactAssessment"}]},{"title":"Strength of Recommendation Rating","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"strength-of-recommendation","display":"Strength of Recommendation"}],"text":"strengthOfRecommendationRating"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]},"entry":[{"reference":"ArtifactAssessment/179469","type":"ArtifactAssessment"}]},{"title":"Direction of Recommendation","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"direction-of-recommendation","display":"Direction of Recommendation"}],"text":"directionOfRecommendation"},"text":{"status":"generated","div":"Favors intervention"},"entry":[{"reference":"ArtifactAssessment/179469","type":"ArtifactAssessment"}]},{"title":"Other Recommendation Ratings","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"ratings","display":"Ratings"}],"text":"overallRatings"},"text":{"status":"generated","div":"A"},"entry":[{"reference":"ArtifactAssessment/179469","type":"ArtifactAssessment"}]},{"title":"Overall Recommendation Related Items","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"related-items","display":"Related Items"}],"text":"overallRelatedItems"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Discussion","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"discussion","display":"Discussion"}]},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Population","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"population","display":"Population"}],"text":"population"},"text":{"status":"generated","div":"Inclusion Criteria: [[1]] Adults. [[2]] Diagnosed with type 2 diabetes. [[3]] Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods. [[4]] Screened surgical candidates."},"entry":[{"reference":"Group/32139","type":"Group","display":"RecommendationEligibilityCriteria: Eligibility Criteria for Bariatric Surgery (ADA Recommendation 8.16)"}]},{"title":"Action","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"action","display":"Action"}],"text":"action"},"text":{"status":"generated","div":"Metabolic surgery is recommended."},"entry":[{"reference":"PlanDefinition/179468","type":"PlanDefinition","display":"PlanDefinition for Recommendation: ADA Obesity Management Recommendation 8.16"}]},{"title":"Opposite Action","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"opposite-action","display":"Opposite Action"}],"text":"oppositeAction"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Structured Data","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"data-source","display":"Data Source"}],"text":"relatesToDerivedFrom"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}}]},{"title":"Evidence","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"evidence","display":"Evidence"}],"text":"Evidence"},"section":[{"title":"Summary of Findings","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"summary-of-findings","display":"Summary of Findings"}],"text":"summaryOfFindingsSummary"},"text":{"status":"generated","div":"ADA Level of Evidence A. A substantial body of evidence has now been accumulated, including data from numerous randomized controlled (nonblinded) clinical trials, demonstrating that metabolic surgery achieves superior glycemic control and reduction of cardiovascular risk factors in patients with type 2 diabetes and obesity compared with various lifestyle/medical interventions."},"entry":[{"reference":"ArtifactAssessment/179469","type":"ArtifactAssessment"}],"section":[{"title":"Summary of Findings Ratings","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"ratings","display":"Ratings"}],"text":"summaryOfFindingsRatings"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Summary of Findings Related Items","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"related-items","display":"Related Items"}],"text":"summaryOfFindingsRelatedItems"},"text":{"status":"generated","div":"JournalArticleCitation: Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations"},"entry":[{"reference":"ArtifactAssessment/179469","type":"ArtifactAssessment"}]}]},{"title":"Desirable Effects","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"desirable-effects","display":"Desirable Effects"}],"text":"desirableSummary"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]},"section":[{"title":"Desirable Effects Ratings","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"ratings","display":"Ratings"}],"text":"desirableRatings"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Desirable Effects Related Items","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"related-items","display":"Related Items"}],"text":"desirableRelatedItems"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}}]},{"title":"Undesirable Effects Summary","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"undesirable-effects","display":"Undesirable Effects"}],"text":"undesirableSummary"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]},"section":[{"title":"Undesirable Effects Ratings","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"ratings","display":"Ratings"}],"text":"undesirableRatings"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Undesirable Effects Related Items","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"related-items","display":"Related Items"}],"text":"undesirableRelatedItems"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}}]},{"title":"Discussion","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"discussion","display":"Discussion"}]},"text":{"status":"generated","div":"A substantial body of evidence has now been accumulated, including data from numerous randomized controlled (nonblinded) clinical trials, demonstrating that metabolic surgery achieves superior glycemic control and reduction of cardiovascular risk factors in patients with type 2 diabetes and obesity compared with various lifestyle/medical interventions.<br/>In extended follow-up of obese adults with type 2 diabetes randomized to adding gastric bypass compared with lifestyle and intensive medical management alone, there remained a significantly better composite triple end point in the surgical group at 5 years. However, because the effect size diminished over 5 years, further follow-up is needed to understand the durability of the improvement."},"entry":[{"reference":"ArtifactAssessment/179469","type":"ArtifactAssessment"}]},{"title":"Data Source","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"data-source","display":"Data Source"}]},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}}]},{"title":"Net Effect","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"net-effect","display":"Net Effect"}],"text":"Net Effect"},"section":[{"title":"Net Effect (Balance of Benefits/Harms) 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summary:
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