Evidence Based Medicine on FHIR Implementation Guide
2.0.0-ballot - ballot International flag

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

: ComparativeEvidence: Bypass surgery effects on Treatment with opioids in JAMA 2018 Norwegian cohort study - XML Representation

Raw xml | Download


<Evidence xmlns="http://hl7.org/fhir">
  <id value="104156"/>
  <meta>
    <versionId value="9"/>
    <lastUpdated value="2023-12-06T00:51:34.461Z"/>
    <profile
             value="http://hl7.org/fhir/uv/ebm/StructureDefinition/comparative-evidence"/>
    <profile
             value="http://hl7.org/fhir/uv/ebm/StructureDefinition/single-study-evidence"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Evidence 104156</b></p><a name="104156"> </a><a name="hc104156"> </a><a name="104156-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: 2023-12-06 00:51:34+0000</p><p style="margin-bottom: 0px">Profiles: <a href="StructureDefinition-comparative-evidence.html">ComparativeEvidence</a>, <a href="StructureDefinition-single-study-evidence.html">SingleStudyEvidence</a></p></div><p><b>url</b>: <a href="https://fevir.net/resources/Evidence/104156">https://fevir.net/resources/Evidence/104156</a></p><p><b>identifier</b>: FEvIR Object Identifier/104156</p><p><b>name</b>: ComparativeEvidence_Bypass_surgery_effects_on_Treatment_with_opioids_in_JAMA_2018_Norwegian_cohort_study</p><p><b>title</b>: ComparativeEvidence: Bypass surgery effects on Treatment with opioids in JAMA 2018 Norwegian cohort study</p><p><b>status</b>: Active</p><p><b>date</b>: 2022-09-19 21:16:36+0000</p><p><b>publisher</b>: Computable Publishing LLC</p><p><b>contact</b>: <a href="mailto:support@computablepublishing.com">support@computablepublishing.com</a></p><p><b>author</b>: Brian S. Alper: </p><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="CodeSystem-179423.html#179423-evidence-communication">Evidence Based Medicine on FHIR Implementation Guide Code System evidence-communication</a>: Evidence Communication</td><td><span title="Codes:{https://fevir.net/resources/CodeSystem/179423 ComparativeEvidence}">ComparativeEvidence</span></td></tr><tr><td style="display: none">*</td><td><a href="CodeSystem-179423.html#179423-evidence-communication">Evidence Based Medicine on FHIR Implementation Guide Code System evidence-communication</a>: Evidence Communication</td><td><span title="Codes:{https://fevir.net/resources/CodeSystem/179423 SingleStudyEvidence}">SingleStudyEvidence</span></td></tr></table><p><b>copyright</b>: </p><div><p>https://creativecommons.org/licenses/by-nc-sa/4.0/</p>
</div><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: Derived From</p><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://jamanetwork.com/journals/jama/fullarticle/2669729">https://jamanetwork.com/journals/jama/fullarticle/2669729</a></td></tr></table></blockquote><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: Cite As</p><p><b>citation</b>: </p><div><p>ComparativeEvidence: Bypass surgery effects on Treatment with opioids in JAMA 2018 Norwegian cohort study [Evidence]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 104156. Revised 2022-09-19. Available at: https://fevir.net/resources/Evidence/104156. Computable resource at: https://fevir.net/resources/Evidence/104156.</p>
</div></blockquote><p><b>description</b>: </p><div><p>greater risk of 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]</p>
</div><p><b>assertion</b>: </p><div><p>Compared with specialized medical treatment, bariatric surgery may slightly increase the use of opioids.</p>
</div><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: </p><div><p>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).</p>
</div><p><b>variableRole</b>: Population</p><p><b>observed</b>: <a href="Group-178427.html">StudyGroup: Severely Obese Adults 2018 Norwegian Cohort</a></p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: </p><div><p>bariatric surgery vs. specialized medical treatment without bariatric surgery</p>
</div><p><b>variableRole</b>: Exposure</p><p><b>comparatorCategory</b>: no bariatric surgery</p><p><b>intended</b>: <a href="EvidenceVariable-172427.html">GroupAssignment: Bariatric Surgery vs. no bariatric surgery</a></p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: </p><div><p>Treatment with opioids</p>
</div><p><b>variableRole</b>: Outcome</p><p><b>observed</b>: <a href="EvidenceVariable-104119.html">OutcomeVariable: Treatment with opioids</a></p></blockquote><p><b>synthesisType</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/synthesis-type NotApplicable}">not applicable</span></p><p><b>studyDesign</b>: <span title="Codes:{http://hl7.org/fhir/study-design SEVCO:01002}">Observational research</span>, <span title="Codes:{http://hl7.org/fhir/study-design SEVCO:01011}">Parallel cohort design</span>, <span title="Codes:{http://hl7.org/fhir/study-design SEVCO:01028}">Longitudinal data collection</span></p><blockquote><p><b>statistic</b></p><p><b>description</b>: </p><div><p>Relative risk 1.3; 95% CI 1.2 to 1.4</p>
</div><p><b>note</b>: Result observed without bariatric surgery was 15.8%, result observed with bariatric surgery was 19.4%</p><p><b>statisticType</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/statistic-type C93152}">Relative Risk</span></p><p><b>quantity</b>: 1.3</p><h3>SampleSizes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>NumberOfStudies</b></td><td><b>NumberOfParticipants</b></td><td><b>KnownDataCount</b></td></tr><tr><td style="display: none">*</td><td>1</td><td>1888</td><td>1888</td></tr></table><h3>AttributeEstimates</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Description</b></td><td><b>Type</b></td><td><b>Level</b></td><td><b>Range</b></td></tr><tr><td style="display: none">*</td><td><div><p>95% CI 1.2 to 1.4</p>
</div></td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/attribute-estimate-type C53324}">Confidence interval</span></td><td>0.95</td><td>1.2-1.4</td></tr></table></blockquote><h3>Certainties</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Description</b></td><td><b>Type</b></td><td><b>Rating</b></td></tr><tr><td style="display: none">*</td><td><div><p>rated down 2 levels due to observational study</p>
</div></td><td><span title="Codes:{http://hl7.org/fhir/certainty-type Overall}">Overall certainty</span></td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/certainty-rating low}">Low quality</span></td></tr></table></div>
  </text>
  <url value="https://fevir.net/resources/Evidence/104156"/>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="ACSN"/>
        <display value="Accession ID"/>
      </coding>
      <text value="FEvIR Object Identifier"/>
    </type>
    <system value="https://fevir.net"/>
    <value value="104156"/>
    <assigner>
      <display value="Computable Publishing LLC"/>
    </assigner>
  </identifier>
  <name
        value="ComparativeEvidence_Bypass_surgery_effects_on_Treatment_with_opioids_in_JAMA_2018_Norwegian_cohort_study"/>
  <title
         value="ComparativeEvidence: Bypass surgery effects on Treatment with opioids in JAMA 2018 Norwegian cohort study"/>
  <status value="active"/>
  <date value="2022-09-19T21:16:36.913Z"/>
  <publisher value="Computable Publishing LLC"/>
  <contact>
    <telecom>
      <system value="email"/>
      <value value="support@computablepublishing.com"/>
    </telecom>
  </contact>
  <author>
    <name value="Brian S. Alper"/>
  </author>
  <useContext>
    <code>
      <system value="https://fevir.net/resources/CodeSystem/179423"/>
      <code value="evidence-communication"/>
      <display value="Evidence Communication"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="https://fevir.net/resources/CodeSystem/179423"/>
        <code value="ComparativeEvidence"/>
        <display value="ComparativeEvidence"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <code>
      <system value="https://fevir.net/resources/CodeSystem/179423"/>
      <code value="evidence-communication"/>
      <display value="Evidence Communication"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="https://fevir.net/resources/CodeSystem/179423"/>
        <code value="SingleStudyEvidence"/>
        <display value="SingleStudyEvidence"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <copyright value="https://creativecommons.org/licenses/by-nc-sa/4.0/"/>
  <relatedArtifact>
    <type value="derived-from"/>
    <document>
      <url value="https://jamanetwork.com/journals/jama/fullarticle/2669729"/>
    </document>
  </relatedArtifact>
  <relatedArtifact>
    <type value="cite-as"/>
    <citation
              value="ComparativeEvidence: Bypass surgery effects on Treatment with opioids in JAMA 2018 Norwegian cohort study [Evidence]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 104156. Revised 2022-09-19. Available at: https://fevir.net/resources/Evidence/104156. Computable resource at: https://fevir.net/resources/Evidence/104156."/>
  </relatedArtifact>
  <description
               value="greater risk of 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]"/>
  <assertion
             value="Compared with specialized medical treatment, bariatric surgery may slightly increase the use of opioids."/>
  <variableDefinition>
    <description
                 value="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)."/>
    <variableRole value="population"/>
    <observed>🔗 
      <reference value="Group/178427"/>
      <type value="Group"/>
      <display
               value="StudyGroup: Severely Obese Adults 2018 Norwegian Cohort"/>
    </observed>
  </variableDefinition>
  <variableDefinition>
    <description
                 value="bariatric surgery vs. specialized medical treatment without bariatric surgery"/>
    <variableRole value="exposure"/>
    <comparatorCategory value="no bariatric surgery"/>
    <intended>🔗 
      <reference value="EvidenceVariable/172427"/>
      <type value="EvidenceVariable"/>
      <display
               value="GroupAssignment: Bariatric Surgery vs. no bariatric surgery"/>
    </intended>
  </variableDefinition>
  <variableDefinition>
    <description value="Treatment with opioids"/>
    <variableRole value="outcome"/>
    <observed>🔗 
      <reference value="EvidenceVariable/104119"/>
      <type value="EvidenceVariable"/>
      <display value="OutcomeVariable: Treatment with opioids"/>
    </observed>
  </variableDefinition>
  <synthesisType>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/synthesis-type"/>
      <code value="NotApplicable"/>
      <display value="not applicable"/>
    </coding>
  </synthesisType>
  <studyDesign>
    <coding>
      <system value="http://hl7.org/fhir/study-design"/>
      <code value="SEVCO:01002"/>
      <display value="Observational research"/>
    </coding>
  </studyDesign>
  <studyDesign>
    <coding>
      <system value="http://hl7.org/fhir/study-design"/>
      <code value="SEVCO:01011"/>
      <display value="Parallel cohort design"/>
    </coding>
  </studyDesign>
  <studyDesign>
    <coding>
      <system value="http://hl7.org/fhir/study-design"/>
      <code value="SEVCO:01028"/>
      <display value="Longitudinal data collection"/>
    </coding>
  </studyDesign>
  <statistic>
    <description value="Relative risk 1.3; 95% CI 1.2 to 1.4"/>
    <note>
      <text
            value="Result observed without bariatric surgery was 15.8%, result observed with bariatric surgery was 19.4%"/>
    </note>
    <statisticType>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/statistic-type"/>
        <code value="C93152"/>
        <display value="Relative Risk"/>
      </coding>
    </statisticType>
    <quantity>
      <value value="1.3"/>
    </quantity>
    <sampleSize>
      <numberOfStudies value="1"/>
      <numberOfParticipants value="1888"/>
      <knownDataCount value="1888"/>
    </sampleSize>
    <attributeEstimate>
      <description value="95% CI 1.2 to 1.4"/>
      <type>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/attribute-estimate-type"/>
          <code value="C53324"/>
          <display value="Confidence interval"/>
        </coding>
      </type>
      <level value="0.95"/>
      <range>
        <low>
          <value value="1.2"/>
        </low>
        <high>
          <value value="1.4"/>
        </high>
      </range>
    </attributeEstimate>
  </statistic>
  <certainty>
    <description value="rated down 2 levels due to observational study"/>
    <type>
      <coding>
        <system value="http://hl7.org/fhir/certainty-type"/>
        <code value="Overall"/>
        <display value="Overall certainty"/>
      </coding>
    </type>
    <rating>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
        <code value="low"/>
        <display value="Low quality"/>
      </coding>
    </rating>
  </certainty>
</Evidence>