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
{
"resourceType" : "Evidence",
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"lastUpdated" : "2024-06-24T19:15:18.127Z"
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Evidence 55</b></p><a name=\"55\"> </a><a name=\"hc55\"> </a><a name=\"55-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: 28; Last updated: 2024-06-24 19:15:18+0000</p></div><p><b>url</b>: <a href=\"https://fevir.net/resources/Evidence/55\">https://fevir.net/resources/Evidence/55</a></p><p><b>identifier</b>: FEvIR Object Identifier/55, <code>https://gps.health/coka</code>/143</p><p><b>version</b>: 4</p><p><b>name</b>: Fourteen_day_mortality_remdesivir_vs_placebo_meta_analysis_ACTT_1_Wang_et_al_WHO_SOLIDARITY</p><p><b>title</b>: 14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY)</p><p><b>citeAs</b>: <a href=\"Citation-58.html\">Alper BS, Dehnbostel J, Shahin K. 14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY). Fast Evidence Interoperability Resources (FEvIR) Platform, entry 55, version 4. Created 2020 Dec 17. Revised 2020 Dec 21. Accessed 2021 Mar 13. Computable resource at: https://fevir.net/resources/Evidence/55.</a></p><p><b>status</b>: Active</p><p><b>date</b>: 2021-08-23 12:33:29+0000</p><p><b>approvalDate</b>: 2020-12-17</p><p><b>lastReviewDate</b>: 2020-12-21</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: , Joanne Dehnbostel: , Khalid Shahin: </p><p><b>copyright</b>: </p><div><p>https://creativecommons.org/licenses/by-nc-sa/4.0/</p>\n</div><h3>RelatedArtifacts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Display</b></td><td><b>Citation</b></td><td><b>Resource</b></td></tr><tr><td style=\"display: none\">*</td><td>Citation</td><td>Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial</td><td> </td><td><code>http://computablepublishing.us/fevir/resources/Citation/4932</code></td></tr><tr><td style=\"display: none\">*</td><td>Citation</td><td>Remdesivir for the Treatment of Covid-19 - Final Report</td><td> </td><td> </td></tr><tr><td style=\"display: none\">*</td><td>Citation</td><td>Repurposed Antiviral Drugs for Covid-19 — Interim WHO Solidarity Trial Results</td><td> </td><td> </td></tr><tr><td style=\"display: none\">*</td><td>Cite As</td><td> </td><td><div><p>14-day mortality remdesivir vs placebo meta-analysis (ACTT-1, Wang et al, WHO SOLIDARITY) [Database Entry: FHIR Evidence Resource]. Contributors: Brian S. Alper, Joanne Dehnbostel, Khalid Shahin [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 55. Published 2020-12-17. Revised 2021-08-23. Available at: https://fevir.net/resources/Evidence/55. Computable resource at: https://fevir.net/resources/Evidence/55.</p>\n</div></td><td> </td></tr></table><p><b>description</b>: </p><div><p>COVID-19 pneumonia remdesivir vs. placebo 14-day mortality (779 events among 6,744 participants, 3 randomized trials)\nRisk ratio 0.85 (95% CI 0.74 to 0.96) in fixed-effect analysis\nRisk ratio 0.81 (95% CI 0.60 to 1.08) in random-effects analysis</p>\n</div><p><b>assertion</b>: </p><div><p>Remdesivir might reduce 14-day mortality, but this finding has not been repeated in a second trial (Low certainty)</p>\n</div><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: </p><div><p>Adults with COVID-19 pneumonia admitted to hospital</p>\n</div><p><b>variableRole</b>: Population</p><p><b>observed</b>: <a href=\"Group-179799.html\">MetaanalysisStudyGroup: Effect Estimates for Mortality at 14 days from COVID19 Remdesivir vs. Placebo RCTs (Biegel 2020 data 35/541 vs. 61/521) (Wang 2020 data 15/153 vs. 7/78) (SOLIDARITY data 219/2743 vs. 219/2708)</a></p><p><b>intended</b>: <a href=\"Group-12714.html\">COVID-19PneumoniaHospitalizedAdult</a></p><p><b>directnessMatch</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/directness high}\">High quality match between observed and intended variable</span></p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: </p><div><p>Remdesivir IV 200 mg once then 100 mg once daily for 9 days</p>\n</div><p><b>variableRole</b>: Exposure</p><p><b>observed</b>: <a href=\"Group-179783.html\">Remdesivir IV 200 mg once then 100 mg once daily for 9 days</a></p><p><b>intended</b>: <a href=\"EvidenceVariable-12717.html\">Remdesivir</a></p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: </p><div><p>Placebo</p>\n</div><p><b>note</b>: SOLIDARITY trial did not use placebo in control group</p><p><b>variableRole</b>: Exposure</p><p><b>observed</b>: <a href=\"EvidenceVariable-12718.html\">Placebo</a></p><p><b>intended</b>: <a href=\"EvidenceVariable-12718.html\">Placebo</a></p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: </p><div><p>Mortality at 14 days</p>\n</div><p><b>variableRole</b>: Outcome</p><p><b>observed</b>: <a href=\"EvidenceVariable-12719.html\">Mortality at 14 days</a></p><p><b>intended</b>: <a href=\"EvidenceVariable-12719.html\">Mortality at 14 days</a></p></blockquote><p><b>studyDesign</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/181513 SEVCO:01003}\">randomized assignment</span></p><blockquote><p><b>statistic</b></p><p><b>description</b>: </p><div><p>risk ratio 0.85 (95% CI 0.74 to 0.96) in fixed-effect meta-analysis; Test for overall effect Z = 2.52 (p = 0.01); Heterogeneity Chi-squared = 7.33, df = 2 (p 0.03), I-squared = 73%</p>\n</div><p><b>statisticType</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/statistic-type C93152}\">Relative Risk</span></p><p><b>quantity</b>: 0.85</p><p><b>numberOfEvents</b>: 779</p><p><b>numberAffected</b>: 779</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>3</td><td>6774</td><td>6744</td></tr></table><blockquote><p><b>attributeEstimate</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/attribute-estimate-type C53324}\">Confidence interval</span></p><p><b>level</b>: 0.95</p><p><b>range</b>: 0.74-0.96</p></blockquote><blockquote><p><b>attributeEstimate</b></p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/181513 TBD:0000077}\">Z-score</span></p><p><b>quantity</b>: 2.52</p></blockquote><blockquote><p><b>attributeEstimate</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/attribute-estimate-type C44185}\">P-value</span></p><p><b>quantity</b>: 0.01</p></blockquote><blockquote><p><b>attributeEstimate</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/attribute-estimate-type 0000420}\">I-squared</span></p><p><b>quantity</b>: 0.73</p></blockquote><blockquote><p><b>attributeEstimate</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/attribute-estimate-type 0000419}\">Cochran's Q statistic</span></p><p><b>quantity</b>: 7.33</p><h3>AttributeEstimates</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Quantity</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/181513 STATO:0000069}\">degrees of freedom</span></td><td>2</td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/attribute-estimate-type C44185}\">P-value</span></td><td>0.03</td></tr></table></blockquote><blockquote><p><b>modelCharacteristic</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/statistic-model-code effectsFixed}\">Fixed-effects</span></p><p><b>applied</b>: true</p></blockquote><blockquote><p><b>modelCharacteristic</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/statistic-model-code metaAnalysis}\">Meta-analysis</span></p><p><b>applied</b>: true</p></blockquote></blockquote><blockquote><p><b>statistic</b></p><p><b>description</b>: </p><div><p>risk ratio 0.81 (95% CI 0.60 to 1.08) in random-effects meta-analysis; Test for overall effect Z = 1.44 (p = 0.15); Heterogeneity Chi-squared = 7.33, df = 2 (p 0.03), I-squared = 73%; Tau-squared = 0.04</p>\n</div><p><b>note</b>: We consider the random-effects model more appropriate for interpretation as the true effect of remdesivir is likely different across the different populations represented in each trial.</p><p><b>statisticType</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/statistic-type C93152}\">Relative Risk</span></p><p><b>quantity</b>: 0.81</p><p><b>numberOfEvents</b>: 779</p><p><b>numberAffected</b>: 779</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>3</td><td>6774</td><td>6744</td></tr></table><blockquote><p><b>attributeEstimate</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/attribute-estimate-type C53324}\">Confidence interval</span></p><p><b>level</b>: 0.95</p><p><b>range</b>: 0.6-1.08</p></blockquote><blockquote><p><b>attributeEstimate</b></p><p><b>type</b>: <span title=\"Codes:{https://fevir.net/resources/CodeSystem/181513 TBD:0000077}\">Z-score</span></p><p><b>quantity</b>: 1.44</p></blockquote><blockquote><p><b>attributeEstimate</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/attribute-estimate-type C44185}\">P-value</span></p><p><b>quantity</b>: 0.15</p></blockquote><blockquote><p><b>attributeEstimate</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/attribute-estimate-type 0000421}\">Tau squared</span></p><p><b>quantity</b>: 0.04</p></blockquote><blockquote><p><b>attributeEstimate</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/attribute-estimate-type 0000420}\">I-squared</span></p><p><b>quantity</b>: 0.73</p></blockquote><blockquote><p><b>attributeEstimate</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/attribute-estimate-type 0000419}\">Cochran's Q statistic</span></p><p><b>quantity</b>: 7.33</p><h3>AttributeEstimates</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Quantity</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/179423 defined-in-text}\">degrees of freedom</span></td><td>2</td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/attribute-estimate-type C44185}\">P-value</span></td><td>0.03</td></tr></table></blockquote><blockquote><p><b>modelCharacteristic</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/statistic-model-code effectsRandom}\">Random-effects</span></p><p><b>applied</b>: true</p></blockquote><blockquote><p><b>modelCharacteristic</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/statistic-model-code metaAnalysis}\">Meta-analysis</span></p><p><b>applied</b>: true</p></blockquote><blockquote><p><b>modelCharacteristic</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/statistic-model-code tauDersimonianLaird}\">Dersimonian-Laird method</span></p><p><b>applied</b>: true</p></blockquote></blockquote><blockquote><p><b>certainty</b></p><p><b>description</b>: </p><div><p>Low certainty due to inconsistency and risk of bias</p>\n</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:{http://hl7.org/fhir/certainty-rating low}\">Low quality</span></p><blockquote><p><b>subcomponent</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-type PublicationBias}\">Publication bias</span></p><p><b>rating</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-rating no-concern}\">no serious concern</span></p></blockquote><blockquote><p><b>subcomponent</b></p><p><b>note</b>: There is a high degree of heterogeneity (I-squared = 73%). There is also inconsistency in findings between the fixed-effect and random-effects statistical models.</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-type Inconsistency}\">Inconsistency</span></p><p><b>rating</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-rating serious-concern}\">serious concern</span></p></blockquote><blockquote><p><b>subcomponent</b></p><p><b>note</b>: Although the random-effects analysis finds an estimate without statistical significance, this imprecision is explained by the inconsistency (heterogeneity) and thus not further downrated in certainty assessment.</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-type Imprecision}\">Imprecision</span></p><p><b>rating</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-rating no-concern}\">no serious concern</span></p></blockquote><blockquote><p><b>subcomponent</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-type Indirectness}\">Indirectness</span></p><p><b>rating</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-rating no-concern}\">no serious concern</span></p></blockquote><blockquote><p><b>subcomponent</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-type RiskOfBias}\">Risk of bias</span></p><p><b>rating</b>: <span title=\"Codes:{http://hl7.org/fhir/certainty-rating serious-concern}\">serious concern</span></p><h3>Subcomponents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Note</b></td><td><b>Type</b></td><td><b>Rating</b></td></tr><tr><td style=\"display: none\">*</td><td>No blinding (no placebo control) in the largest trial</td><td><span title=\"Codes:{https://fevir.net/resources/CodeSystem/181513 SEVCO:00035}\">Lack of blinding</span></td><td><span title=\"Codes:{http://hl7.org/fhir/certainty-rating present}\">present</span></td></tr></table></blockquote></blockquote></div>"
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"quantity" : {
"value" : 2
}
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/attribute-estimate-type",
"code" : "C44185",
"display" : "P-value"
}
]
},
"quantity" : {
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}
}
]
}
],
"modelCharacteristic" : [
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/statistic-model-code",
"code" : "effectsFixed",
"display" : "Fixed-effects",
"userSelected" : true
}
]
},
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},
{
"code" : {
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{
"system" : "http://hl7.org/fhir/statistic-model-code",
"code" : "metaAnalysis",
"display" : "Meta-analysis",
"userSelected" : true
}
]
},
"applied" : true
}
]
},
{
"description" : "risk ratio 0.81 (95% CI 0.60 to 1.08) in random-effects meta-analysis; Test for overall effect Z = 1.44 (p = 0.15); Heterogeneity Chi-squared = 7.33, df = 2 (p 0.03), I-squared = 73%; Tau-squared = 0.04",
"note" : [
{
"text" : "We consider the random-effects model more appropriate for interpretation as the true effect of remdesivir is likely different across the different populations represented in each trial."
}
],
"statisticType" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/statistic-type",
"version" : "0.1.0",
"code" : "C93152",
"display" : "Relative Risk",
"userSelected" : true
}
]
},
"quantity" : {
"value" : 0.81
},
"numberOfEvents" : 779,
"numberAffected" : 779,
"sampleSize" : {
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"numberOfParticipants" : 6774,
"knownDataCount" : 6744
},
"attributeEstimate" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/attribute-estimate-type",
"code" : "C53324",
"display" : "Confidence interval"
}
]
},
"level" : 0.95,
"range" : {
"low" : {
"value" : 0.6
},
"high" : {
"value" : 1.08
}
}
},
{
"type" : {
"coding" : [
{
"system" : "https://fevir.net/resources/CodeSystem/181513",
"code" : "TBD:0000077",
"display" : "Z-score"
}
]
},
"quantity" : {
"value" : 1.44
}
},
{
"type" : {
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{
"system" : "http://terminology.hl7.org/CodeSystem/attribute-estimate-type",
"code" : "C44185",
"display" : "P-value"
}
]
},
"quantity" : {
"value" : 0.15
}
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/attribute-estimate-type",
"code" : "0000421",
"display" : "Tau squared"
}
]
},
"quantity" : {
"value" : 0.04
}
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/attribute-estimate-type",
"code" : "0000420",
"display" : "I-squared"
}
]
},
"quantity" : {
"value" : 0.73
}
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/attribute-estimate-type",
"code" : "0000419",
"display" : "Cochran's Q statistic"
}
]
},
"quantity" : {
"value" : 7.33
},
"attributeEstimate" : [
{
"type" : {
"coding" : [
{
"system" : "https://fevir.net/resources/CodeSystem/179423",
"code" : "defined-in-text",
"display" : "Defined in text"
}
],
"text" : "degrees of freedom"
},
"quantity" : {
"value" : 2
}
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/attribute-estimate-type",
"code" : "C44185",
"display" : "P-value"
}
]
},
"quantity" : {
"value" : 0.03
}
}
]
}
],
"modelCharacteristic" : [
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/statistic-model-code",
"code" : "effectsRandom",
"display" : "Random-effects",
"userSelected" : true
}
]
},
"applied" : true
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/statistic-model-code",
"code" : "metaAnalysis",
"display" : "Meta-analysis",
"userSelected" : true
}
]
},
"applied" : true
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/statistic-model-code",
"code" : "tauDersimonianLaird",
"display" : "Dersimonian-Laird method",
"userSelected" : true
}
]
},
"applied" : true
}
]
}
],
"certainty" : [
{
"description" : "Low certainty due to inconsistency and risk of bias",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-type",
"code" : "Overall",
"display" : "Overall certainty"
}
]
},
"rating" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "low",
"display" : "Low quality"
}
]
},
"subcomponent" : [
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-type",
"code" : "PublicationBias",
"display" : "Publication bias"
}
]
},
"rating" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "no-concern",
"display" : "no serious concern"
}
]
}
},
{
"note" : [
{
"text" : "There is a high degree of heterogeneity (I-squared = 73%). There is also inconsistency in findings between the fixed-effect and random-effects statistical models."
}
],
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-type",
"code" : "Inconsistency",
"display" : "Inconsistency"
}
]
},
"rating" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "serious-concern",
"display" : "serious concern"
}
]
}
},
{
"note" : [
{
"text" : "Although the random-effects analysis finds an estimate without statistical significance, this imprecision is explained by the inconsistency (heterogeneity) and thus not further downrated in certainty assessment."
}
],
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-type",
"code" : "Imprecision",
"display" : "Imprecision"
}
]
},
"rating" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "no-concern",
"display" : "no serious concern"
}
]
}
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-type",
"code" : "Indirectness",
"display" : "Indirectness"
}
]
},
"rating" : {
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{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "no-concern",
"display" : "no serious concern"
}
]
}
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-type",
"code" : "RiskOfBias",
"display" : "Risk of bias"
}
]
},
"rating" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "serious-concern",
"display" : "serious concern"
}
]
},
"subcomponent" : [
{
"note" : [
{
"text" : "No blinding (no placebo control) in the largest trial"
}
],
"type" : {
"coding" : [
{
"system" : "https://fevir.net/resources/CodeSystem/181513",
"code" : "SEVCO:00035",
"display" : "Inadequate blinding of participants"
}
],
"text" : "Lack of blinding"
},
"rating" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/certainty-rating",
"code" : "present",
"display" : "present"
}
]
}
}
]
}
]
}
]
}
IG © 2024+ HL7 International / Clinical Decision Support. Package hl7.fhir.uv.ebm#2.0.0-ballot based on FHIR 6.0.0-ballot2. Generated 2024-11-21
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