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 2024-12-19 |
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<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Citation 33089</b></p><a name="33089"> </a><a name="hc33089"> </a><a name="33089-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: 9; Last updated: 2024-07-18 18:00:38+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-33089.html">Citation 27222544 Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations.</a></p><p><b>identifier</b>: FEvIR Object Identifier/33089, <code>https://pubmed.ncbi.nlm.nih.gov</code>/27222544, <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
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This OID may also be used in CD.codeSystem.">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.4.642.40.44.15.41</p><p><b>version</b>: 2.0.0-ballot</p><p><b>title</b>: 27222544 Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations.</p><p><b>status</b>: Active</p><p><b>date</b>: 2024-12-19 14:29:51+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>
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</div></td></tr></table><h3>Abstracts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Text</b></td><td><b>Copyright</b></td></tr><tr><td style="display: none">*</td><td><div><p><strong>BACKGROUND:</strong> Despite growing evidence that bariatric/metabolic surgery powerfully improves type 2 diabetes (T2D), existing diabetes treatment algorithms do not include surgical options.
<strong>AIM:</strong> The 2nd Diabetes Surgery Summit (DSS-II), an international consensus conference, was convened in collaboration with leading diabetes organizations to develop global guidelines to inform clinicians and policymakers about benefits and limitations of metabolic surgery for T2D.
<strong>METHODS:</strong> A multidisciplinary group of 48 international clinicians/scholars (75% nonsurgeons), including representatives of leading diabetes organizations, participated in DSS-II. After evidence appraisal (MEDLINE [1 January 2005-30 September 2015]), three rounds of Delphi-like questionnaires were used to measure consensus for 32 data-based conclusions. These drafts were presented at the combined DSS-II and 3rd World Congress on Interventional Therapies for Type 2 Diabetes (London, U.K., 28-30 September 2015), where they were open to public comment by other professionals and amended face-to-face by the Expert Committee.
<strong>RESULTS:</strong> Given its role in metabolic regulation, the gastrointestinal tract constitutes a meaningful target to manage T2D. Numerous randomized clinical trials, albeit mostly short/midterm, demonstrate that metabolic surgery achieves excellent glycemic control and reduces cardiovascular risk factors. On the basis of such evidence, metabolic surgery should be recommended to treat T2D in patients with class III obesity (BMI ≥40 kg/m(2)) and in those with class II obesity (BMI 35.0-39.9 kg/m(2)) when hyperglycemia is inadequately controlled by lifestyle and optimal medical therapy. Surgery should also be considered for patients with T2D and BMI 30.0-34.9 kg/m(2) if hyperglycemia is inadequately controlled despite optimal treatment with either oral or injectable medications. These BMI thresholds should be reduced by 2.5 kg/m(2) for Asian patients.
<strong>CONCLUSIONS:</strong> Although additional studies are needed to further demonstrate long-term benefits, there is sufficient clinical and mechanistic evidence to support inclusion of metabolic surgery among antidiabetes interventions for people with T2D and obesity. To date, the DSS-II guidelines have been formally endorsed by 45 worldwide medical and scientific societies. Health care regulators should introduce appropriate reimbursement policies.</p>
</div></td><td><div><p>© 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.</p>
</div></td></tr></table><blockquote><p><b>relatesTo</b></p><p><b>type</b>: comment-in</p><p><b>classifier</b>: <span title="Codes:{https://meshb.nlm.nih.gov/ D016420}">Comment</span></p><p><b>citation</b>: </p><div><p>Nat Rev Endocrinol. 2016 Sep;12(9):500-2. doi: 10.1038/nrendo.2016.111</p>
</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/27388983/">https://pubmed.ncbi.nlm.nih.gov/27388983/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/27388983</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: comment-in</p><p><b>classifier</b>: <span title="Codes:{https://meshb.nlm.nih.gov/ D016420}">Comment</span></p><p><b>citation</b>: </p><div><p>Diabetes Care. 2016 Nov;39(11):e201. doi: 10.2337/dc16-1416</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/27926900/">https://pubmed.ncbi.nlm.nih.gov/27926900/</a></td></tr></table><p><b>resourceReference</b>: Identifier: <code>https://pubmed.ncbi.nlm.nih.gov</code>/27926900</p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: comment-in</p><p><b>classifier</b>: <span title="Codes:{https://meshb.nlm.nih.gov/ D016420}">Comment</span></p><p><b>citation</b>: </p><div><p>Diabetes Care. 2017 Jul;40(7):e90-e91. doi: 10.2337/dc16-2403</p>
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Australia.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc33089/contributor6">Del Prato S</a></p><p><b>forenameInitials</b>: S</p><p><b>affiliation</b>: University of Pisa, Pisa, Italy.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc33089/contributor7">Ji L</a></p><p><b>forenameInitials</b>: L</p><p><b>affiliation</b>: Peking University, Beijing, China.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc33089/contributor8">Sadikot SM</a></p><p><b>forenameInitials</b>: SM</p><p><b>affiliation</b>: Diabetes India, Mumbai, India.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc33089/contributor9">Herman WH</a></p><p><b>forenameInitials</b>: WH</p><p><b>affiliation</b>: University of Michigan, Ann Arbor, MI.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc33089/contributor10">Amiel SA</a></p><p><b>forenameInitials</b>: SA</p><p><b>affiliation</b>: King's College London, London, U.K.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc33089/contributor11">Kaplan LM</a></p><p><b>forenameInitials</b>: LM</p><p><b>affiliation</b>: Harvard Medical School, Boston, MA.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc33089/contributor12">Taroncher-Oldenburg G</a></p><p><b>forenameInitials</b>: G</p><p><b>affiliation</b>: Philadelphia, PA.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc33089/contributor13">Cummings DE</a></p><p><b>forenameInitials</b>: DE</p><p><b>affiliation</b>: University of Washington, Seattle, WA francesco.rubino@kcl.ac.uk davidec@u.washington.edu.</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc33089/contributor14">Delegates of the 2nd Diabetes Surgery Summit</a></p></blockquote></blockquote></blockquote><hr/><blockquote><p 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value="**BACKGROUND:** Despite growing evidence that bariatric/metabolic surgery powerfully improves type 2 diabetes (T2D), existing diabetes treatment algorithms do not include surgical options.
**AIM:** The 2nd Diabetes Surgery Summit (DSS-II), an international consensus conference, was convened in collaboration with leading diabetes organizations to develop global guidelines to inform clinicians and policymakers about benefits and limitations of metabolic surgery for T2D.
**METHODS:** A multidisciplinary group of 48 international clinicians/scholars (75% nonsurgeons), including representatives of leading diabetes organizations, participated in DSS-II. After evidence appraisal (MEDLINE [1 January 2005-30 September 2015]), three rounds of Delphi-like questionnaires were used to measure consensus for 32 data-based conclusions. These drafts were presented at the combined DSS-II and 3rd World Congress on Interventional Therapies for Type 2 Diabetes (London, U.K., 28-30 September 2015), where they were open to public comment by other professionals and amended face-to-face by the Expert Committee.
**RESULTS:** Given its role in metabolic regulation, the gastrointestinal tract constitutes a meaningful target to manage T2D. Numerous randomized clinical trials, albeit mostly short/midterm, demonstrate that metabolic surgery achieves excellent glycemic control and reduces cardiovascular risk factors. On the basis of such evidence, metabolic surgery should be recommended to treat T2D in patients with class III obesity (BMI ≥40 kg/m(2)) and in those with class II obesity (BMI 35.0-39.9 kg/m(2)) when hyperglycemia is inadequately controlled by lifestyle and optimal medical therapy. Surgery should also be considered for patients with T2D and BMI 30.0-34.9 kg/m(2) if hyperglycemia is inadequately controlled despite optimal treatment with either oral or injectable medications. These BMI thresholds should be reduced by 2.5 kg/m(2) for Asian patients.
**CONCLUSIONS:** Although additional studies are needed to further demonstrate long-term benefits, there is sufficient clinical and mechanistic evidence to support inclusion of metabolic surgery among antidiabetes interventions for people with T2D and obesity. To date, the DSS-II guidelines have been formally endorsed by 45 worldwide medical and scientific societies. Health care regulators should introduce appropriate reimbursement policies."/>
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<type value="Practitioner"/>
<display value="Zimmet PZ"/>
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<forenameInitials value="PZ"/>
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<display
value="Monash University, Melbourne, Victoria, Australia."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor6"/>
<type value="Practitioner"/>
<display value="Del Prato S"/>
</contributor>
<forenameInitials value="S"/>
<affiliation>
<display value="University of Pisa, Pisa, Italy."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor7"/>
<type value="Practitioner"/>
<display value="Ji L"/>
</contributor>
<forenameInitials value="L"/>
<affiliation>
<display value="Peking University, Beijing, China."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor8"/>
<type value="Practitioner"/>
<display value="Sadikot SM"/>
</contributor>
<forenameInitials value="SM"/>
<affiliation>
<display value="Diabetes India, Mumbai, India."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor9"/>
<type value="Practitioner"/>
<display value="Herman WH"/>
</contributor>
<forenameInitials value="WH"/>
<affiliation>
<display value="University of Michigan, Ann Arbor, MI."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor10"/>
<type value="Practitioner"/>
<display value="Amiel SA"/>
</contributor>
<forenameInitials value="SA"/>
<affiliation>
<display value="King's College London, London, U.K."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor11"/>
<type value="Practitioner"/>
<display value="Kaplan LM"/>
</contributor>
<forenameInitials value="LM"/>
<affiliation>
<display value="Harvard Medical School, Boston, MA."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor12"/>
<type value="Practitioner"/>
<display value="Taroncher-Oldenburg G"/>
</contributor>
<forenameInitials value="G"/>
<affiliation>
<display value="Philadelphia, PA."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor13"/>
<type value="Practitioner"/>
<display value="Cummings DE"/>
</contributor>
<forenameInitials value="DE"/>
<affiliation>
<display
value="University of Washington, Seattle, WA francesco.rubino@kcl.ac.uk davidec@u.washington.edu."/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor14"/>
<type value="Organization"/>
<display value="Delegates of the 2nd Diabetes Surgery Summit"/>
</contributor>
</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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