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
| Active as of 2022-09-06 |
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<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Citation 104116</b></p><a name="104116"> </a><a name="hc104116"> </a><a name="104116-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: 14; Last updated: 2024-07-18 17:44:34+0000</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-journal-article-citation.html">JournalArticleCitation</a></p></div><p><b>url</b>: <a href="Citation-104116.html">Citation JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort</a></p><p><b>identifier</b>: FEvIR Object Identifier/104116, <code>https://pubmed.ncbi.nlm.nih.gov</code>/29340680, <a href="http://terminology.hl7.org/6.1.0/NamingSystem-uri.html" title="As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt
This oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid:
Note that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.
This OID may also be used in CD.codeSystem.">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.4.642.40.44.15.38</p><p><b>version</b>: 2.0.0-ballot</p><p><b>title</b>: JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort</p><p><b>status</b>: Active</p><p><b>date</b>: 2022-09-06 14:07:55+0000</p><p><b>publisher</b>: HL7 International / Clinical Decision Support</p><p><b>contact</b>: HL7 International / Clinical Decision Support: <a href="http://www.hl7.org/Special/committees/dss">http://www.hl7.org/Special/committees/dss</a></p><p><b>description</b>: </p><div><p>This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide.</p>
</div><h3>UseContexts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td><a href="http://hl7.org/fhir/R5/codesystem-citation-classification-type.html#citation-classification-type-fevir-platform-use">Citation Classification Type fevir-platform-use</a>: FEvIR Platform Use</td><td><span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier project-specific}">Project Specific</span></td></tr></table><p><b>jurisdiction</b>: <span title="Codes:{http://unstats.un.org/unsd/methods/m49/m49.htm 001}">World</span></p><p><b>copyright</b>: </p><div><p>https://creativecommons.org/licenses/by-nc-sa/4.0/</p>
</div><p><b>approvalDate</b>: 2018-01-26</p><p><b>lastReviewDate</b>: 2022-03-30</p><p><b>author</b>: Brian S. Alper: , Computable Publishing®: MEDLINE-to-FEvIR Converter: , Joanne Dehnbostel: </p><h3>Summaries</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Style</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/citation-summary-style comppub}">Computable Publishing</span></td><td><div><p>Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities [Journal Article]. Contributors: Jakobsen GS, Småstuen MC, Sandbu R, Nordstrand N, Hofsø D, Lindberg M, Hertel JK, Hjelmesæth J. In: JAMA, PMID 29340680. Published January 16, 2018. Available at: https://pubmed.ncbi.nlm.nih.gov/29340680/.</p>
</div></td></tr></table><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/citation-classification-type citation-source}">Citation Source</span></p><p><b>classifier</b>: <span title="Codes:">MEDLINE</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/citation-classification-type medline-owner}">MEDLINE Citation Owner</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#owner_value NLM}">National Library of Medicine, Index Section</span></p></blockquote><p><b>currentState</b>: <span title="Codes:{http://hl7.org/fhir/citation-status-type medline-medline}">Medline Citation Status of MEDLINE</span>, <span title="Codes:{http://hl7.org/fhir/citation-status-type pubmed-publication-status-ppublish}">PubMed PublicationStatus of ppublish</span></p><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title="Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-entrez}">PubMed Pubstatus of Entrez</span></p><p><b>period</b>: ?? --> 2018-01-18 06:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title="Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-pubmed}">PubMed Pubstatus of PubMed</span></p><p><b>period</b>: ?? --> 2018-01-18 06:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title="Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-medline}">PubMed Pubstatus of Medline</span></p><p><b>period</b>: ?? --> 2018-01-27 06:00:00+0000</p></blockquote><blockquote><p><b>citedArtifact</b></p><p><b>identifier</b>: <code>https://pubmed.ncbi.nlm.nih.gov</code>/29340680, pii/2669729, <code>https://doi.org</code>/10.1001/jama.2017.21055, <code>https://www.ncbi.nlm.nih.gov/pmc/</code>/PMC5833560</p><h3>Titles</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Language</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/title-type primary}">Primary title</span></td><td><span title="Codes:{urn:ietf:bcp:47 en}">English</span></td><td><div><p>Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities.</p>
</div></td></tr></table><h3>Abstracts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/cited-artifact-abstract-type primary-human-use}">Primary human use</span></td><td><div><p><strong>Importance:</strong> The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain.
<strong>Objective:</strong> To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment.
<strong>Design, Setting, and Participants:</strong> Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (n = 2109) with severe obesity assessed (221 patients excluded and 1888 patients included).
<strong>Exposures:</strong> Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs.
<strong>Main Outcomes and Measures:</strong> Primary outcomes included remission and new onset of hypertension based on drugs dispensed according to the Norwegian Prescription Database. Prespecified secondary outcomes included changes in comorbidities. Adverse events included complications retrieved from the Norwegian Patient Registry and a local laboratory database.
<strong>Results:</strong> Among 1888 patients included in the study, the mean (SD) age was 43.5 (12.3) years (1249 women [66%]; mean [SD] baseline BMI, 44.2 [6.1]; 100% completed follow-up at a median of 6.5 years [range, 0.2-10.1]). Surgically treated patients had a greater likelihood of remission and lesser likelihood for new onset of hypertension (remission: absolute risk [AR], 31.9% vs 12.4%); risk difference [RD], 19.5% [95% CI, 15.8%-23.2%], relative risk [RR], 2.1 [95% CI, 2.0-2.2]; new onset: AR, 3.5% vs 12.2%, RD, 8.7% [95% CI, 6.7%-10.7%], RR, 0.4 [95% CI, 0.3-0.5]; greater likelihood of diabetes remission: AR, 57.5% vs 14.8%; RD, 42.7% [95% CI, 35.8%-49.7%], RR, 3.9 [95% CI, 2.8-5.4]; greater risk of new-onset depression: AR, 8.9% vs 6.5%; RD, 2.4% [95% CI, 1.3%-3.5%], RR, 1.5 [95% CI, 1.4-1.7]; and treatment with opioids: AR, 19.4% vs 15.8%, RD, 3.6% [95% CI, 2.3%-4.9%], RR, 1.3 [95% CI, 1.2-1.4]). Surgical patients had a greater risk for undergoing at least 1 additional gastrointestinal surgical procedure (AR, 31.3% vs 15.5%; RD, 15.8% [95% CI, 13.1%-18.5%]; RR, 2.0 [95% CI, 1.7-2.4]). The proportion of patients with low ferritin levels was significantly greater in the surgical group (26% vs 12%, P < .001).
<strong>Conclusions and Relevance:</strong> Among patients with severe obesity followed up for a median of 6.5 years, bariatric surgery compared with medical treatment was associated with a clinically important increased risk for complications, as well as lower risks of obesity-related comorbidities. The risk for complications should be considered in the decision-making process.</p>
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</div><h3>Documents</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Url</b></td></tr><tr><td style="display: none">*</td><td><a href="https://pubmed.ncbi.nlm.nih.gov/26895675/">https://pubmed.ncbi.nlm.nih.gov/26895675/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/26895675</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Obesity (Silver Spring). 2014 Jul;22 Suppl 2:S5-39</p>
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IM}">IM</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">MeSH heading</span></p><p><b>artifactAssessment</b>: <a href="#hc104116/meshHeading0">ArtifactAssessment: artifact[x] = this resource</a></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type knowledge-artifact-type}">Knowledge Artifact Type</span></p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>artifactAssessment</b>: Classifier added by Computable Publishing LLC</p></blockquote><blockquote><p><b>contributorship</b></p><p><b>complete</b>: true</p><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc104116/contributor0">Jakobsen GS</a></p><p><b>forenameInitials</b>: GS</p><p><b>affiliation</b>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc104116/contributor1">Småstuen MC</a></p><p><b>forenameInitials</b>: MC</p><p><b>affiliation</b>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc104116/contributor2">Sandbu R</a></p><p><b>forenameInitials</b>: R</p><p><b>affiliation</b>: </p><ul><li>Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</li><li>Department of Surgery, Vestfold Hospital Trust, Tønsberg, Norway.</li></ul></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc104116/contributor3">Nordstrand N</a></p><p><b>forenameInitials</b>: N</p><p><b>affiliation</b>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc104116/contributor4">Hofsø D</a></p><p><b>forenameInitials</b>: D</p><p><b>affiliation</b>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc104116/contributor5">Lindberg M</a></p><p><b>forenameInitials</b>: M</p><p><b>affiliation</b>: Department of Laboratory Medicine, Vestfold Hospital Trust, Tønsberg, Norway.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc104116/contributor6">Hertel JK</a></p><p><b>forenameInitials</b>: JK</p><p><b>affiliation</b>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc104116/contributor7">Hjelmesæth J</a></p><p><b>forenameInitials</b>: J</p><p><b>affiliation</b>: </p><ul><li>Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</li><li>Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, 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value="**Importance:** The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain.
**Objective:** To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment.
**Design, Setting, and Participants:** Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (n = 2109) with severe obesity assessed (221 patients excluded and 1888 patients included).
**Exposures:** Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs.
**Main Outcomes and Measures:** Primary outcomes included remission and new onset of hypertension based on drugs dispensed according to the Norwegian Prescription Database. Prespecified secondary outcomes included changes in comorbidities. Adverse events included complications retrieved from the Norwegian Patient Registry and a local laboratory database.
**Results:** Among 1888 patients included in the study, the mean (SD) age was 43.5 (12.3) years (1249 women [66%]; mean [SD] baseline BMI, 44.2 [6.1]; 100% completed follow-up at a median of 6.5 years [range, 0.2-10.1]). Surgically treated patients had a greater likelihood of remission and lesser likelihood for new onset of hypertension (remission: absolute risk [AR], 31.9% vs 12.4%); risk difference [RD], 19.5% [95% CI, 15.8%-23.2%], relative risk [RR], 2.1 [95% CI, 2.0-2.2]; new onset: AR, 3.5% vs 12.2%, RD, 8.7% [95% CI, 6.7%-10.7%], RR, 0.4 [95% CI, 0.3-0.5]; greater likelihood of diabetes remission: AR, 57.5% vs 14.8%; RD, 42.7% [95% CI, 35.8%-49.7%], RR, 3.9 [95% CI, 2.8-5.4]; greater risk of new-onset depression: AR, 8.9% vs 6.5%; RD, 2.4% [95% CI, 1.3%-3.5%], RR, 1.5 [95% CI, 1.4-1.7]; and treatment with opioids: AR, 19.4% vs 15.8%, RD, 3.6% [95% CI, 2.3%-4.9%], RR, 1.3 [95% CI, 1.2-1.4]). Surgical patients had a greater risk for undergoing at least 1 additional gastrointestinal surgical procedure (AR, 31.3% vs 15.5%; RD, 15.8% [95% CI, 13.1%-18.5%]; RR, 2.0 [95% CI, 1.7-2.4]). The proportion of patients with low ferritin levels was significantly greater in the surgical group (26% vs 12%, P &lt; .001).
**Conclusions and Relevance:** Among patients with severe obesity followed up for a median of 6.5 years, bariatric surgery compared with medical treatment was associated with a clinically important increased risk for complications, as well as lower risks of obesity-related comorbidities. The risk for complications should be considered in the decision-making process."/>
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</classifier>
</classification>
<classification>
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<system
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<code value="chemical"/>
<display value="Chemical"/>
<userSelected value="false"/>
</coding>
</type>
<classifier>
<coding>
<system
value="https://www.cas.org/support/documentation/chemical-substances"/>
<code value="9007-73-2"/>
<userSelected value="false"/>
</coding>
<coding>
<system value="https://meshb.nlm.nih.gov/"/>
<code value="D005293"/>
<display value="Ferritins"/>
<userSelected value="false"/>
</coding>
</classifier>
</classification>
<classification>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="publication-type"/>
<display value="Publication type"/>
</coding>
</type>
<classifier>
<coding>
<system value="https://meshb.nlm.nih.gov/"/>
<code value="D003160"/>
<display value="Comparative Study"/>
<userSelected value="false"/>
</coding>
</classifier>
<classifier>
<coding>
<system value="https://meshb.nlm.nih.gov/"/>
<code value="D016428"/>
<display value="Journal Article"/>
<userSelected value="false"/>
</coding>
</classifier>
</classification>
<classification>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="citation-subset"/>
<display value="Citation subset"/>
<userSelected value="false"/>
</coding>
</type>
<classifier>
<coding>
<system
value="https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#citationsubset"/>
<code value="IM"/>
<display value="IM"/>
<userSelected value="false"/>
</coding>
</classifier>
</classification>
<classification>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
</type>
<artifactAssessment>
<reference value="#meshHeading0"/>
<type value="ArtifactAssessment"/>
</artifactAssessment>
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<classification>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="knowledge-artifact-type"/>
<display value="Knowledge Artifact Type"/>
<userSelected value="false"/>
</coding>
</type>
<classifier>
<coding>
<system value="http://hl7.org/fhir/citation-artifact-classifier"/>
<code value="D016428"/>
<display value="Journal Article"/>
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<artifactAssessment>
<display value="Classifier added by Computable Publishing LLC"/>
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<entry>
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<reference value="#contributor0"/>
<type value="Practitioner"/>
<display value="Jakobsen GS"/>
</contributor>
<forenameInitials value="GS"/>
<affiliation>
<display
value="Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway."/>
</affiliation>
</entry>
<entry>
<contributor>
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<type value="Practitioner"/>
<display value="Småstuen MC"/>
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<forenameInitials value="MC"/>
<affiliation>
<display
value="Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway."/>
</affiliation>
</entry>
<entry>
<contributor>
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<type value="Practitioner"/>
<display value="Sandbu R"/>
</contributor>
<forenameInitials value="R"/>
<affiliation>
<display
value="Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway."/>
</affiliation>
<affiliation>
<display
value="Department of Surgery, Vestfold Hospital Trust, Tønsberg, Norway."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor3"/>
<type value="Practitioner"/>
<display value="Nordstrand N"/>
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<forenameInitials value="N"/>
<affiliation>
<display
value="Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor4"/>
<type value="Practitioner"/>
<display value="Hofsø D"/>
</contributor>
<forenameInitials value="D"/>
<affiliation>
<display
value="Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor5"/>
<type value="Practitioner"/>
<display value="Lindberg M"/>
</contributor>
<forenameInitials value="M"/>
<affiliation>
<display
value="Department of Laboratory Medicine, Vestfold Hospital Trust, Tønsberg, Norway."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor6"/>
<type value="Practitioner"/>
<display value="Hertel JK"/>
</contributor>
<forenameInitials value="JK"/>
<affiliation>
<display
value="Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor7"/>
<type value="Practitioner"/>
<display value="Hjelmesæth J"/>
</contributor>
<forenameInitials value="J"/>
<affiliation>
<display
value="Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway."/>
</affiliation>
<affiliation>
<display
value="Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway."/>
</affiliation>
</entry>
</contributorship>
</citedArtifact>
</Citation>
IG © 2024+ HL7 International / Clinical Decision Support. Package hl7.fhir.uv.ebm#2.0.0-ballot based on FHIR 6.0.0-ballot2. Generated 2024-12-19
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