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
<Evidence xmlns="http://hl7.org/fhir">
<id value="236960"/>
<meta>
<versionId value="61"/>
<lastUpdated value="2024-10-03T13:11:20.368Z"/>
<profile
value="http://hl7.org/fhir/uv/ebm/StructureDefinition/comparative-evidence"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Evidence 236960</b></p><a name="236960"> </a><a name="hc236960"> </a><a name="236960-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: 61; Last updated: 2024-10-03 13:11:20+0000</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-comparative-evidence.html">ComparativeEvidence</a></p></div><p><b>url</b>: <a href="https://fevir.net/resources/Evidence/236960">https://fevir.net/resources/Evidence/236960</a></p><p><b>identifier</b>: FEvIR Object Identifier/236960, outcomeId/313958, picoId/85798, sectionId/73215</p><p><b>name</b>: Nonfatal_myocardial_infarctionfrom_MAGICapp_313958</p><p><b>title</b>: MAGIC-derived Evidence: Nonfatal myocardial infarction with SGLT2 inhibitors vs. GLP-1 RA in Adults with type 2 diabetes</p><p><b>status</b>: Active</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>: Computable Publishing®: MAGIC-to-FEvIR Converter: </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></table><p><b>copyright</b>: </p><div><p>https://creativecommons.org/licenses/by-nc-sa/4.0/</p>
</div><h3>RelatedArtifacts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>ResourceReference</b></td></tr><tr><td style="display: none">*</td><td>Part Of</td><td>MAGICapp Conversion Report: SGLT2 inhibitors and GLP-1 RA for type 2 diabetes (Identifier: FEvIR Linking Identifier/MAGIC-5288-j1Wqrn-conversion-report)</td></tr></table><p><b>description</b>: </p><div><p>This Evidence Resource is referenced in an example for the EBMonFHIR Implementation Guide.</p>
</div><p><b>assertion</b>: </p><div><p>There is no important difference between SGLT2 inhibitors and GLP-1 receptor agonists on the risk of nonfatal myocardial infarction.</p>
</div><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: </p><div><p>Adults with type 2 diabetes</p>
</div><p><b>variableRole</b>: Population</p><p><b>observed</b>: <a href="Group-236947.html">Adults with type 2 diabetes and CVD and CKD</a></p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: </p><div><p>GroupAssignment: SGLT2 inhibitors vs. GLP-1 RA</p>
</div><p><b>variableRole</b>: Exposure</p><p><b>comparatorCategory</b>: GLP-1 RA</p><p><b>observed</b>: <a href="EvidenceVariable-236950.html">GroupAssignment: SGLT2 inhibitors vs. GLP-1 RA</a></p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: </p><div><p>Nonfatal myocardial infarction</p>
</div><p><b>variableRole</b>: Outcome</p><p><b>observed</b>: <a href="EvidenceVariable-236959.html">Nonfatal myocardial infarction</a></p></blockquote><p><b>synthesisType</b>: <span title="Codes:">SYSTEMATIC_REVIEW</span></p><p><b>studyDesign</b>: <span title="Codes:">NOTSET</span></p><blockquote><p><b>statistic</b></p><p><b>description</b>: </p><div><p>Risk Difference -0.7% (CI95 -2.4% to 1.1%)</p>
</div><p><b>statisticType</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/statistic-type 0000424}">Risk Difference</span></p><p><b>quantity</b>: -0.007</p><h3>SampleSizes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>NumberOfStudies</b></td><td><b>NumberOfParticipants</b></td></tr><tr><td style="display: none">*</td><td>1</td><td>463</td></tr></table><h3>AttributeEstimates</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Range</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">CI95</span></td><td>-0.024-0.011</td></tr></table></blockquote><blockquote><p><b>statistic</b></p><p><b>description</b>: </p><div><p>OR 0.95 (CI95 0.84 to 1.08)</p>
</div><p><b>statisticType</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/statistic-type C16932}">Odds Ratio</span></p><p><b>quantity</b>: 0.95</p><h3>SampleSizes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>NumberOfStudies</b></td><td><b>NumberOfParticipants</b></td></tr><tr><td style="display: none">*</td><td>1</td><td>463</td></tr></table><h3>AttributeEstimates</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Range</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">CI95</span></td><td>0.84-1.08</td></tr></table></blockquote><blockquote><p><b>certainty</b></p><p><b>description</b>: </p><div><p>Due to serious imprecision</p>
</div><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/certainty-type Overall}">Overall certainty</span></p><p><b>rating</b>: <span title="Codes:{https://fevir.net/resources/CodeSystem/27834 RJCS-2004}">Moderate certainty</span></p><h3>Subcomponents</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Rating</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">Risk of Bias</span></td><td><span title="Codes:">NOTSET</span></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">Inconsistency</span></td><td><span title="Codes:">NOTSET</span></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">Indirectness</span></td><td><span title="Codes:">NOTSET</span></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">Imprecision</span></td><td><span title="Codes:">NOTSET</span></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">Publication Bias</span></td><td><span title="Codes:">NOTSET</span></td></tr></table></blockquote></div>
</text>
<url value="https://fevir.net/resources/Evidence/236960"/>
<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="236960"/>
<assigner>
<display value="Computable Publishing LLC"/>
</assigner>
</identifier>
<identifier>
<type>
<text value="outcomeId"/>
</type>
<system value="https://app.magicapp.org/#/guidelines"/>
<value value="313958"/>
</identifier>
<identifier>
<type>
<text value="picoId"/>
</type>
<system value="https://app.magicapp.org/#/guidelines"/>
<value value="85798"/>
</identifier>
<identifier>
<type>
<text value="sectionId"/>
</type>
<system value="https://app.magicapp.org/#/guidelines"/>
<value value="73215"/>
</identifier>
<name value="Nonfatal_myocardial_infarctionfrom_MAGICapp_313958"/>
<title
value="MAGIC-derived Evidence: Nonfatal myocardial infarction with SGLT2 inhibitors vs. GLP-1 RA in Adults with type 2 diabetes"/>
<status value="active"/>
<publisher value="Computable Publishing LLC"/>
<contact>
<telecom>
<system value="email"/>
<value value="support@computablepublishing.com"/>
</telecom>
</contact>
<author>
<name value="Computable Publishing®: MAGIC-to-FEvIR Converter"/>
</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>
<copyright value="https://creativecommons.org/licenses/by-nc-sa/4.0/"/>
<relatedArtifact>
<type value="part-of"/>
<resourceReference>
<type value="Composition"/>
<identifier>
<type>
<text value="FEvIR Linking Identifier"/>
</type>
<system value="https://fevir.net/FLI"/>
<value value="MAGIC-5288-j1Wqrn-conversion-report"/>
<assigner>
<display value="Computable Publishing LLC"/>
</assigner>
</identifier>
<display
value="MAGICapp Conversion Report: SGLT2 inhibitors and GLP-1 RA for type 2 diabetes"/>
</resourceReference>
</relatedArtifact>
<description
value="This Evidence Resource is referenced in an example for the EBMonFHIR Implementation Guide."/>
<assertion
value="There is no important difference between SGLT2 inhibitors and GLP-1 receptor agonists on the risk of nonfatal myocardial infarction."/>
<variableDefinition>
<description value="Adults with type 2 diabetes"/>
<variableRole value="population"/>
<observed>🔗
<reference value="Group/236947"/>
<type value="Group"/>
<identifier>
<type>
<text value="FEvIR Linking Identifier"/>
</type>
<system value="https://fevir.net/FLI"/>
<value value="MAGIC-5288-j1Wqrn-population-group-85394-85798"/>
<assigner>
<display value="Computable Publishing LLC"/>
</assigner>
</identifier>
<display value="Adults with type 2 diabetes and CVD and CKD"/>
</observed>
</variableDefinition>
<variableDefinition>
<description value="GroupAssignment: SGLT2 inhibitors vs. GLP-1 RA"/>
<variableRole value="exposure"/>
<comparatorCategory value="GLP-1 RA"/>
<observed>🔗
<reference value="EvidenceVariable/236950"/>
<type value="EvidenceVariable"/>
<identifier>
<type>
<text value="FEvIR Linking Identifier"/>
</type>
<system value="https://fevir.net/FLI"/>
<value value="MAGIC-5288-j1Wqrn-group-assignment-85394-85798"/>
<assigner>
<display value="Computable Publishing LLC"/>
</assigner>
</identifier>
<display value="GroupAssignment: SGLT2 inhibitors vs. GLP-1 RA"/>
</observed>
</variableDefinition>
<variableDefinition>
<description value="Nonfatal myocardial infarction"/>
<variableRole value="outcome"/>
<observed>🔗
<reference value="EvidenceVariable/236959"/>
<type value="EvidenceVariable"/>
<identifier>
<type>
<text value="FEvIR Linking Identifier"/>
</type>
<system value="https://fevir.net/FLI"/>
<value value="MAGIC-5288-j1Wqrn-313958"/>
<assigner>
<display value="Computable Publishing LLC"/>
</assigner>
</identifier>
<display value="Nonfatal myocardial infarction"/>
</observed>
</variableDefinition>
<synthesisType>
<text value="SYSTEMATIC_REVIEW"/>
</synthesisType>
<studyDesign>
<text value="NOTSET"/>
</studyDesign>
<statistic>
<description value="Risk Difference -0.7% (CI95 -2.4% to 1.1%)"/>
<statisticType>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/statistic-type"/>
<version value="5.0.0-cibuild"/>
<code value="0000424"/>
<display value="Risk Difference"/>
</coding>
</statisticType>
<quantity>
<value value="-0.007"/>
</quantity>
<sampleSize>
<numberOfStudies value="1"/>
<numberOfParticipants value="463"/>
</sampleSize>
<attributeEstimate>
<type>
<text value="CI95"/>
</type>
<range>
<low>
<value value="-0.024"/>
</low>
<high>
<value value="0.011"/>
</high>
</range>
</attributeEstimate>
</statistic>
<statistic>
<description value="OR 0.95 (CI95 0.84 to 1.08)"/>
<statisticType>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/statistic-type"/>
<version value="5.0.0-cibuild"/>
<code value="C16932"/>
<display value="Odds Ratio"/>
</coding>
</statisticType>
<quantity>
<value value="0.95"/>
</quantity>
<sampleSize>
<numberOfStudies value="1"/>
<numberOfParticipants value="463"/>
</sampleSize>
<attributeEstimate>
<type>
<text value="CI95"/>
</type>
<range>
<low>
<value value="0.84"/>
</low>
<high>
<value value="1.08"/>
</high>
</range>
</attributeEstimate>
</statistic>
<certainty>
<description value="Due to serious imprecision"/>
<type>
<coding>
<system value="http://hl7.org/fhir/certainty-type"/>
<code value="Overall"/>
<display value="Overall certainty"/>
</coding>
</type>
<rating>
<coding>
<system value="https://fevir.net/resources/CodeSystem/27834"/>
<code value="RJCS-2004"/>
<display value="Moderate certainty"/>
</coding>
</rating>
<subcomponent>
<type>
<text value="Risk of Bias"/>
</type>
<rating>
<text value="NOTSET"/>
</rating>
</subcomponent>
<subcomponent>
<type>
<text value="Inconsistency"/>
</type>
<rating>
<text value="NOTSET"/>
</rating>
</subcomponent>
<subcomponent>
<type>
<text value="Indirectness"/>
</type>
<rating>
<text value="NOTSET"/>
</rating>
</subcomponent>
<subcomponent>
<type>
<text value="Imprecision"/>
</type>
<rating>
<text value="NOTSET"/>
</rating>
</subcomponent>
<subcomponent>
<type>
<text value="Publication Bias"/>
</type>
<rating>
<text value="NOTSET"/>
</rating>
</subcomponent>
</certainty>
</Evidence>