Evidence Based Medicine on FHIR Implementation Guide
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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

: MAGIC-derived Evidence: Heart failure with SGLT2 inhibitors vs. GLP-1 RA in Adults with type 2 diabetes - XML Representation

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<Evidence xmlns="http://hl7.org/fhir">
  <id value="236969"/>
  <meta>
    <versionId value="64"/>
    <lastUpdated value="2024-12-14T08:46:28.847Z"/>
    <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 236969</b></p><a name="236969"> </a><a name="hc236969"> </a><a name="236969-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: 64; Last updated: 2024-12-14 08:46:28+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/236969">https://fevir.net/resources/Evidence/236969</a></p><p><b>identifier</b>: FEvIR Object Identifier/https://fevir.net/FOI/236969, outcomeId/313961, picoId/85798, sectionId/73215</p><p><b>name</b>: Heart_failure_from_MAGICapp_313961</p><p><b>title</b>: MAGIC-derived Evidence: Heart failure 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>SGLT2 inhibitors reduce the risk of heart failure compared with GLP-1 receptor agonists.</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>Heart failure</p>
</div><p><b>variableRole</b>: Outcome</p><p><b>observed</b>: <a href="EvidenceVariable-236968.html">Hospital admission for heart failure</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 -4.8% (CI95 -6.6% to -2.7%)</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>: -0.048</p><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>-0.066--0.027</td></tr></table></blockquote><blockquote><p><b>statistic</b></p><p><b>description</b>: </p><div><p>OR 0.74 (CI95 0.65 to 0.85)</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>: 0.74</p><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>0.65-0.85</td></tr></table></blockquote><blockquote><p><b>certainty</b></p><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-2003}">High 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/236969"/>
  <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="urn:ietf:rfc:3986"/>
    <value value="https://fevir.net/FOI/236969"/>
    <assigner>
      <display value="Computable Publishing LLC"/>
    </assigner>
  </identifier>
  <identifier>
    <type>
      <text value="outcomeId"/>
    </type>
    <system value="https://app.magicapp.org/#/guidelines"/>
    <value value="313961"/>
  </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="Heart_failure_from_MAGICapp_313961"/>
  <title
         value="MAGIC-derived Evidence: Heart failure 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="SGLT2 inhibitors reduce the risk of heart failure compared with GLP-1 receptor agonists."/>
  <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="Heart failure"/>
    <variableRole value="outcome"/>
    <observed>🔗 
      <reference value="EvidenceVariable/236968"/>
      <type value="EvidenceVariable"/>
      <identifier>
        <type>
          <text value="FEvIR Linking Identifier"/>
        </type>
        <system value="https://fevir.net/FLI"/>
        <value value="MAGIC-5288-j1Wqrn-313961"/>
        <assigner>
          <display value="Computable Publishing LLC"/>
        </assigner>
      </identifier>
      <display value="Hospital admission for heart failure"/>
    </observed>
  </variableDefinition>
  <synthesisType>
    <text value="SYSTEMATIC_REVIEW"/>
  </synthesisType>
  <studyDesign>
    <text value="NOTSET"/>
  </studyDesign>
  <statistic>
    <description value="Risk Difference -4.8% (CI95 -6.6% to -2.7%)"/>
    <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="-0.048"/>
    </quantity>
    <attributeEstimate>
      <type>
        <text value="CI95"/>
      </type>
      <range>
        <low>
          <value value="-0.066"/>
        </low>
        <high>
          <value value="-0.027"/>
        </high>
      </range>
    </attributeEstimate>
  </statistic>
  <statistic>
    <description value="OR 0.74 (CI95 0.65 to 0.85)"/>
    <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="0.74"/>
    </quantity>
    <attributeEstimate>
      <type>
        <text value="CI95"/>
      </type>
      <range>
        <low>
          <value value="0.65"/>
        </low>
        <high>
          <value value="0.85"/>
        </high>
      </range>
    </attributeEstimate>
  </statistic>
  <certainty>
    <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-2003"/>
        <display value="High 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>