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

Example Evidence: ComparatorOnlyEvidence: All-cause mortality without bariatric surgery in 2022 meta-analysis

Generated Narrative: Evidence 104384

version: 13; Last updated: 2023-12-03 10:00:31+0000

Profiles: ComparatorOnlyEvidence, EvidenceSynthesisEvidence

url: https://fevir.net/resources/Evidence/104384

identifier: FEvIR Object Identifier/104384

name: AllCauseMortalityControlGroup2022metaAnalysis

title: ComparatorOnlyEvidence: All-cause mortality without bariatric surgery in 2022 meta-analysis

status: Active

date: 2022-09-19 21:15:10+0000

publisher: Computable Publishing LLC

contact: support@computablepublishing.com

author: Brian S. Alper:

copyright:

https://creativecommons.org/licenses/by-nc-sa/4.0/

relatedArtifact

type: Derived From

label: data source

citation:

Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis [Journal Article]. Contributors: van Veldhuisen SL, Gorter TM, van Woerden G, de Boer RA, Rienstra M, Hazebroek EJ, van Veldhuisen DJ. In: European heart journal, PMID 35243488. Published March 04, 2022. Available at: https://pubmed.ncbi.nlm.nih.gov/35243488/.

Documents

-Url
*https://academic.oup.com/eurheartj/article/43/20/1955/6542137

relatedArtifact

type: Supported With

classifier: Citation Resource for the original article

display: Citation Resource for 2022 Systematic Review of bariatric surgery mortality effect - PMID 35243488

resourceReference: StudyCitation: 2022 Systematic Review of bariatric surgery mortality effect 35243488

relatedArtifact

type: Cite As

citation:

ComparatorOnlyEvidence: All-cause mortality without bariatric surgery in 2022 meta-analysis [Evidence]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 104384. Revised 2022-09-19. Available at: https://fevir.net/resources/Evidence/104384. Computable resource at: https://fevir.net/resources/Evidence/104384.

description:

estimate for all-cause mortality without bariatric surgery 4.75% based on median control event rate in 26 cohort studies with post-bariatric surgery patients and obese controls

variableDefinition

description:

obese, adult (age ≥18 years old) patients who had No weight-loss surgical intervention NOTE: note.text is used artificially to support the EBMonFHIR Implementation Guide and the following content would more properly be found in a note.text element: Studies were considered eligible if they were designed to study outcomes in obese patients who underwent a weight-loss surgical intervention in comparison with an age, sex, and BMI matched control group who did not undergo a weight-loss surgical intervention. We searched for randomized controlled trials, prospective or retrospective longitudinal cohort studies, and case–control studies. For the control group, all non-surgical treatment options for obesity (e.g. intensive lifestyle intervention, standard of care, or no specific therapy) were accepted. Studies were excluded if (i) patients were not matched for age, sex, and BMI; (ii) the presence of one or more outcome parameters of interest (e.g. HF, AF, coronary artery disease) was required for inclusion; or (iii) if study groups were not representative in relation to the general population of patients with obesity (e.g. patients could only be included in the presence of a specific comorbidity, for instance, end-stage renal disease). The third criterium did not apply to Type 2 diabetes, thus studies that only included patients with Type 2 diabetes could be eligible for inclusion. As the control group (observed reference exposure) was defined differently in each study, the intended reference exposure is described as the absence of the intended exposure (Bariatric Surgery).

variableRole: Population

intended: ComparatorGroup: Obese patients ≥ 18 years old without bariatric surgery

variableDefinition

description:

All-cause mortality NOTE: note.text is used artificially to support the EBMonFHIR Implementation Guide and the following content would more properly be found in a note.text element: The observed element can reference an EvidenceVariable Resource that defines the outcome measured through structured characteristics. For example, 'Mean difference in HbA1c at 12 months' or 'Mean difference in HbA1c at end of study'. The structured characteristics can be references to the Evidence instances for each of the included studies, in which case this is a direct link to the dataset used for analysis. The intended element can reference an EvidenceVariable Resource that expresses the outcome intended for evidence application through structured characteristics. The structured characteristics could be used to express the SR eligibility criteria for study outcomes (as a subset of eligibility criteria for studies).

variableRole: Outcome

observed: We searched for randomized controlled trials, prospective or retrospective longitudinal cohort studies, and case–control studies. For the control group, all non-surgical treatment options for obesity (e.g. intensive lifestyle intervention, standard of care, or no specific therapy) were accepted. Studies were excluded if (i) patients were not matched for age, sex, and BMI; (ii) the presence of one or more outcome parameters of interest (e.g. HF, AF, coronary artery disease) was required for inclusion; or (iii) if study groups were not representative in relation to the general population of patients with obesity (e.g. patients could only be included in the presence of a specific comorbidity, for instance, end-stage renal disease). The third criterium did not apply to Type 2 diabetes, thus studies that only included patients with Type 2 diabetes could be eligible for inclusion.

intended: OutcomeVariable: All-cause mortality

synthesisType: median of pooled rates

studyDesign: Observational research, Parallel cohort design, Matching for comparison

statistic

description:

median pooled rate 4.75% (range 1.4% to 28.2%) among 26 studies with control event rates

statisticType: Proportion

quantity: 0.0475

SampleSizes

-NumberOfStudies
*26

AttributeEstimates

-DescriptionTypeRange
*

range 1.4% to 28.2%

Range0.014-0.282

ModelCharacteristics

-Code
*median value of proportions