Evidence Based Medicine on FHIR Implementation Guide
2.0.0-ballot - ballot
Evidence Based Medicine on FHIR Implementation Guide
2.0.0-ballot - 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
{
"resourceType" : "ArtifactAssessment",
"id" : "179700",
"meta" : {
"versionId" : "5",
"lastUpdated" : "2023-12-06T14:24:23.708Z",
"profile" : [
🔗 "http://hl7.org/fhir/uv/ebm/StructureDefinition/comparison"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ArtifactAssessment 179700</b></p><a name=\"179700\"> </a><a name=\"hc179700\"> </a><a name=\"179700-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: 5; Last updated: 2023-12-06 14:24:23+0000</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-comparison.html\">Comparison</a></p></div><p><b>ArtifactAssessmentCompared</b>: <a href=\"Composition-179699.html\">Recommendation: ADA Obesity Management Recommendation 8.16-adapted</a></p><p><b>Artifact URL</b>: <a href=\"https://fevir.net/resources/ArtifactAssessment/179700\">https://fevir.net/resources/ArtifactAssessment/179700</a></p><p><b>Artifact Description</b>: </p><div><p>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.</p>\n</div><p><b>identifier</b>: FEvIR Object Identifier/179700</p><p><b>title</b>: Comparison: Original and Adapted Recommendation: ADA Obesity Management Recommendation 8.16</p><p><b>citeAs</b>: </p><div><p>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.</p>\n</div><p><b>artifact</b>: <a href=\"Composition-179466.html\">Recommendation: ADA Obesity Management Recommendation 8.16</a></p><blockquote><p><b>content</b></p><p><b>informationType</b>: Container</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 PrimitiveElement}\">Primitive Element</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 string-datatype}\">string Datatype</span></p><p><b>path</b>: resourceType</p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>summary</b>: </p><div><p>Composition</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContent}\">Original Resource Content</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>InformationType</b></td><td><b>Summary</b></td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td>Comment</td><td><div><p>Composition</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparedResourceContent}\">Compared Resource Content</span></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 string-datatype}\">string Datatype</span></td></tr></table></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Rating</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparisonOfResources}\">Comparison of Resources Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 same}\">Same</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Change Request</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 SuggestedChange}\">Suggested Change to Resource Content</span></p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Container</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 PrimitiveElement}\">Primitive Element</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 string-datatype}\">string Datatype</span></p><p><b>path</b>: <a href=\"http://hl7.org/fhir/R5/datatypes.html#id\">id</a></p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>summary</b>: </p><div><p>179466</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContent}\">Original Resource Content</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>InformationType</b></td><td><b>Summary</b></td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td>Comment</td><td><div><p>179699</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparedResourceContent}\">Compared Resource Content</span></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 string-datatype}\">string Datatype</span></td></tr></table></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Rating</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparisonOfResources}\">Comparison of Resources Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 different}\">Different</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Change Request</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 SuggestedChange}\">Suggested Change to Resource Content</span></p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Container</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ObjectElement}\">Object Element</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsMeta}\">Manage as Meta</span></p><p><b>path</b>: meta</p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContent}\">Original Resource Content</span></p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>summary</b>: </p><div><p>{"versionId":"15","lastUpdated":"2023-11-24T19:36:33.794Z","profile":["http://hl7.org/fhir/uv/ebm/StructureDefinition/recommendation"]}</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparedResourceContent}\">Compared Resource Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsMeta}\">Manage as Meta</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>InformationType</b></td><td><b>Summary</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>Comment</td><td><div><p>{"versionId":"1","lastUpdated":"2023-11-28T15:35:24.114Z","profile":["http://hl7.org/fhir/uv/ebm/StructureDefinition/recommendation"]}</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></td></tr></table></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Rating</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparisonOfResources}\">Comparison of Resources Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 different}\">Different</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Change Request</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 SuggestedChange}\">Suggested Change to Resource Content</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Container</p><p><b>summary</b>: </p><div><p>{"versionId":"15","lastUpdated":"2023-11-24T19:36:33.794Z","profile":["http://hl7.org/fhir/uv/ebm/StructureDefinition/recommendation"]}</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ContainedElementAdaptation}\">Contained Element Adaptation</span></p><p><b>path</b>: meta</p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Container</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 PrimitiveElement}\">Primitive Element</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 string-datatype}\">string Datatype</span></p><p><b>path</b>: <a href=\"http://hl7.org/fhir/R5/datatypes.html#url\">url</a></p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>summary</b>: </p><div><p>https://fevir.net/resources/Composition/179466</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContent}\">Original Resource Content</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>InformationType</b></td><td><b>Summary</b></td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td>Comment</td><td><div><p>https://fevir.net/resources/Composition/179699</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparedResourceContent}\">Compared Resource Content</span></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 string-datatype}\">string Datatype</span></td></tr></table></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Rating</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparisonOfResources}\">Comparison of Resources Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 different}\">Different</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Change Request</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 SuggestedChange}\">Suggested Change to Resource Content</span></p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Container</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ArrayElement}\">Array Element</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsIdentifier}\">Manage as Identifier</span></p><p><b>path</b>: identifier</p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContent}\">Original Resource Content</span></p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>summary</b>: </p><div><p>[{"type":{"text":"FEvIR Object Identifier"},"system":"https://fevir.net","value":"179466","assigner":{"display":"Computable Publishing LLC"}}]</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparedResourceContent}\">Compared Resource Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsarray-of-Identifier}\">Manage as Array of Identifier</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>InformationType</b></td><td><b>Summary</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>Comment</td><td><div><p>[{"type":{"text":"FEvIR Object Identifier"},"system":"https://fevir.net","value":"179699","assigner":{"display":"Computable Publishing LLC"}}]</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></td></tr></table></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Rating</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparisonOfResources}\">Comparison of Resources Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 different}\">Different</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Change Request</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 SuggestedChange}\">Suggested Change to Resource Content</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Container</p><p><b>summary</b>: </p><div><p>[{"type":{"text":"FEvIR Object Identifier"},"system":"https://fevir.net","value":"179466","assigner":{"display":"Computable Publishing LLC"}}]</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ContainedElementAdaptation}\">Contained Element Adaptation</span></p><p><b>path</b>: identifier</p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Container</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 PrimitiveElement}\">Primitive Element</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 string-datatype}\">string Datatype</span></p><p><b>path</b>: status</p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>summary</b>: </p><div><p>final</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContent}\">Original Resource Content</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>InformationType</b></td><td><b>Summary</b></td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td>Comment</td><td><div><p>final</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparedResourceContent}\">Compared Resource Content</span></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 string-datatype}\">string Datatype</span></td></tr></table></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Rating</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparisonOfResources}\">Comparison of Resources Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 same}\">Same</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Change Request</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 SuggestedChange}\">Suggested Change to Resource Content</span></p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Container</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ObjectElement}\">Object Element</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsCodeableConcept}\">Manage as CodeableConcept</span></p><p><b>path</b>: type</p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContent}\">Original Resource Content</span></p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>summary</b>: </p><div><p>{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"EvidenceReport","display":"EvidenceReport"}],"text":"EvidenceReport"}</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparedResourceContent}\">Compared Resource Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsCodeableConcept}\">Manage as CodeableConcept</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>InformationType</b></td><td><b>Summary</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>Comment</td><td><div><p>{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"EvidenceReport","display":"EvidenceReport"}],"text":"EvidenceReport"}</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></td></tr></table></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Rating</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparisonOfResources}\">Comparison of Resources Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 same}\">Same</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Change Request</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 SuggestedChange}\">Suggested Change to Resource Content</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Container</p><p><b>summary</b>: </p><div><p>{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"EvidenceReport","display":"EvidenceReport"}],"text":"EvidenceReport"}</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ContainedElementAdaptation}\">Contained Element Adaptation</span></p><p><b>path</b>: type</p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Container</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ArrayElement}\">Array Element</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsCodeableConcept}\">Manage as CodeableConcept</span></p><p><b>path</b>: category</p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContent}\">Original Resource Content</span></p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>summary</b>: </p><div><p>[{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"Recommendation","display":"Recommendation"}]}]</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparedResourceContent}\">Compared Resource Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsarray-of-CodeableConcept}\">Manage as Array of CodeableConcept</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>InformationType</b></td><td><b>Summary</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>Comment</td><td><div><p>[{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"Recommendation","display":"Recommendation"}]}]</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></td></tr></table></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Rating</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparisonOfResources}\">Comparison of Resources Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 same}\">Same</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Change Request</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 SuggestedChange}\">Suggested Change to Resource Content</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Container</p><p><b>summary</b>: </p><div><p>[{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"Recommendation","display":"Recommendation"}]}]</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ContainedElementAdaptation}\">Contained Element Adaptation</span></p><p><b>path</b>: category</p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Container</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 PrimitiveElement}\">Primitive Element</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 string-datatype}\">string Datatype</span></p><p><b>path</b>: <a href=\"http://hl7.org/fhir/R5/datatypes.html#date\">date</a></p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>summary</b>: </p><div><p>2023-11-24T19:36:33.794Z</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContent}\">Original Resource Content</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>InformationType</b></td><td><b>Summary</b></td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td>Comment</td><td><div><p>2023-11-28T15:35:24.114Z</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparedResourceContent}\">Compared Resource Content</span></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 string-datatype}\">string Datatype</span></td></tr></table></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Rating</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparisonOfResources}\">Comparison of Resources Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 different}\">Different</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Change Request</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 SuggestedChange}\">Suggested Change to Resource Content</span></p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Container</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ArrayElement}\">Array Element</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsReference}\">Manage as Reference</span></p><p><b>path</b>: author</p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContent}\">Original Resource Content</span></p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>summary</b>: </p><div><p>[{"display":"Brian S. Alper"}]</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparedResourceContent}\">Compared Resource Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsarray-of-Reference}\">Manage as Array of Reference</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>InformationType</b></td><td><b>Summary</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>Comment</td><td><div><p>[{"display":"Joanne Dehnbostel"}]</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></td></tr></table></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Rating</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparisonOfResources}\">Comparison of Resources Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 different}\">Different</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Change Request</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 SuggestedChange}\">Suggested Change to Resource Content</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Container</p><p><b>summary</b>: </p><div><p>[{"display":"Brian S. Alper"}]</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ContainedElementAdaptation}\">Contained Element Adaptation</span></p><p><b>path</b>: author</p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Container</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 PrimitiveElement}\">Primitive Element</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 string-datatype}\">string Datatype</span></p><p><b>path</b>: title</p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>summary</b>: </p><div><p>Recommendation: ADA Obesity Management Recommendation 8.16</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContent}\">Original Resource Content</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>InformationType</b></td><td><b>Summary</b></td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td>Comment</td><td><div><p>Recommendation: ADA Obesity Management Recommendation 8.16-adapted</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparedResourceContent}\">Compared Resource Content</span></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 string-datatype}\">string Datatype</span></td></tr></table></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Rating</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparisonOfResources}\">Comparison of Resources Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 different}\">Different</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Change Request</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 SuggestedChange}\">Suggested Change to Resource Content</span></p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Container</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ObjectElement}\">Object Element</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsReference}\">Manage as Reference</span></p><p><b>path</b>: custodian</p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContent}\">Original Resource Content</span></p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>summary</b>: </p><div><p>{"reference":"Organization/118079","type":"Organization","display":"Computable Publishing LLC"}</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparedResourceContent}\">Compared Resource Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsReference}\">Manage as Reference</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>InformationType</b></td><td><b>Summary</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>Comment</td><td><div><p>{"reference":"Organization/118079","type":"Organization","display":"Computable Publishing LLC"}</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></td></tr></table></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Rating</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparisonOfResources}\">Comparison of Resources Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 same}\">Same</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Change Request</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 SuggestedChange}\">Suggested Change to Resource Content</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Container</p><p><b>summary</b>: </p><div><p>{"reference":"Organization/118079","type":"Organization","display":"Computable Publishing LLC"}</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ContainedElementAdaptation}\">Contained Element Adaptation</span></p><p><b>path</b>: custodian</p></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: Container</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ArrayElement}\">Array Element</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsBackboneElement}\">Manage as BackboneElement</span></p><p><b>path</b>: section</p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContent}\">Original Resource Content</span></p><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>summary</b>: </p><div><p>[{"title":"Recommendation Specification","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"recommendation-specification","display":"Recommendation Specification"}],"text":"Recommendation Specification"},"section":[{"title":"Recommendation Statement","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"recommendation-statement","display":"Recommendation Statement"}],"text":"overallSummary"},"text":{"status":"generated","div":"8.16 Metabolic surgery should be a recommended option to treat type 2 diabetes in screened surgical candidates with BMI ≥40 kg/m2 (BMI ≥37.5 kg/m2 in Asian Americans) and in adults with BMI 35.0–39.9 kg/m2 (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. A"},"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) Summary","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"summary","display":"Summary"}],"text":"netEffectSummary"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Net Effect (Balance of Benefits/Harms) Ratings","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"ratings","display":"Ratings"}],"text":"netEffectRatings"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Net Effect (Balance of Benefits/Harms) Related Items","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"related-items","display":"Related Items"}],"text":"netEffectRelatedItems"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Values/Preferences Summary","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"preferences","display":"Preferences"}],"text":"preferencesSummary"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]},"section":[{"title":"Values/Preferences Ratings","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"ratings","display":"Ratings"}],"text":"preferencesRatings"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Values/Preferences Related Items","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"related-items","display":"Related 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Summary","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"justification","display":"Justification"}],"text":"overallJustificationSummary"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]},"section":[{"title":"Overall Justification Ratings","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"ratings","display":"Ratings"}],"text":"overallJustificationRatings"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Overall Justification Related Items","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"related-items","display":"Related Items"}],"text":"overallJustificationRelatedItems"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}}]},{"title":"Problem Importance Summary","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"problem-importance","display":"Problem Importance"}],"text":"problemImportanceSummary"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]},"section":[{"title":"Problem Importance Ratings","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"ratings","display":"Ratings"}],"text":"problemImportanceRatings"},"emptyReason":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/list-empty-reason","code":"notstarted","display":"Not Started"}]}},{"title":"Problem Importance Related 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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"}]}}]}]}]</p>\n</div><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Comment</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparedResourceContent}\">Compared Resource Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 manageAsarray-of-BackboneElement}\">Manage as Array of BackboneElement</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>InformationType</b></td><td><b>Summary</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>Comment</td><td><div><p>[{"title":"Recommendation Specification","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"recommendation-specification","display":"Recommendation Specification"}],"text":"Recommendation Specification"},"section":[{"title":"Recommendation Statement","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"recommendation-statement","display":"Recommendation Statement"}],"text":"overallSummary"},"text":{"status":"additional","div":"8.16 Metabolic surgery should be a recommended option to treat type 2 diabetes in screened surgical candidates with BMI ≥40 kg/m2 (BMI ≥37.5 kg/m2 in Asian Americans) and in adults with BMI 35.0–39.9 kg/m2 (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. "},"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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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":"Competing Interests Related Items","code":{"text":"competingInterestsRelatedItems"},"text":{"status":"empty","div":""},"entry":[]},{"title":"Research Priorities Ratings","code":{"text":"researchConsiderationsRatings"},"text":{"status":"empty","div":""},"entry":[]},{"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"}]}}]},{"title":"Research Priorities Related Items","code":{"text":"researchConsiderationsRelatedItems"},"text":{"status":"empty","div":""},"entry":[]}]}]</p>\n</div></td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 OriginalResourceContentJSON}\">Original Resource Content JSON</span></td></tr></table></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Rating</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 ComparisonOfResources}\">Comparison of Resources Content</span></p><p><b>classifier</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 different}\">Different</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Change Request</p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 SuggestedChange}\">Suggested Change to Resource Content</span></p></blockquote><blockquote><p><b>component</b></p><p><b>informationType</b>: Container</p><p><b>summary</b>: </p><div><p>[{"title":"Recommendation Specification","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"recommendation-specification","display":"Recommendation Specification"}],"text":"Recommendation Specification"},"section":[{"title":"Recommendation Statement","code":{"coding":[{"system":"https://fevir.net/resources/CodeSystem/179423","code":"recommendation-statement","display":"Recommendation Statement"}],"text":"overallSummary"},"text":{"status":"generated","div":"8.16 Metabolic surgery should be a recommended option to treat type 2 diabetes in screened surgical candidates with BMI ≥40 kg/m2 (BMI ≥37.5 kg/m2 in Asian Americans) and in adults with BMI 35.0–39.9 kg/m2 (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. A"},"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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[[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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[[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. 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IG © 2024+ HL7 International / Clinical Decision Support. Package hl7.fhir.uv.ebm#2.0.0-ballot based on FHIR 6.0.0-ballot2. Generated 2024-11-21
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