Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot2 - STU 1 ballot
Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot2 - STU 1 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 1.0.0-ballot2 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
| Page standards status: Informative |
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<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Citation 112</b></p><a name="112"> </a><a name="hc112"> </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: 13; Last updated: 2025-09-13 16:01:00+0000</p></div><p><b>ArtifactPublicationStatus</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-status-type active}">Active</span></p><p><b>url</b>: <a href="Citation-112.html">Citation Efficacy of Corticosteroids in COVID-19 Patients: A Systematic Review and Meta-Analysis</a></p><p><b>identifier</b>: FEvIR Object Identifier/112, <a href="http://terminology.hl7.org/6.5.0/NamingSystem-uri.html" title="As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt
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This OID may also be used in CD.codeSystem.">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.4.642.40.44.15.61</p><p><b>version</b>: 1.0.0-ballot2</p><p><b>title</b>: Efficacy of Corticosteroids in COVID-19 Patients: A Systematic Review and Meta-Analysis</p><p><b>status</b>: Active</p><p><b>date</b>: 2021-09-24 12:06:23+0000</p><p><b>author</b>: Brian S. Alper: </p><p><b>publisher</b>: HL7 International / Clinical Decision Support</p><p><b>contact</b>: HL7 International / Clinical Decision Support: <a href="http://www.hl7.org/Special/committees/dss">http://www.hl7.org/Special/committees/dss</a></p><p><b>description</b>: </p><div><p>A systematic review included in the Steroids SMR Project</p>
</div><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="http://terminology.hl7.org/6.5.0/CodeSystem-usage-context-type.html#usage-context-type-program">UsageContextType program</a>: Program</td><td><span title="Codes:">Steroids SMR Project</span></td></tr><tr><td style="display: none">*</td><td><a href="http://hl7.org/fhir/R5/codesystem-citation-classification-type.html#citation-classification-type-fevir-platform-use">Citation Classification Type fevir-platform-use</a>: FEvIR Platform Use</td><td><span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier project-specific}">Project Specific</span></td></tr></table><p><b>jurisdiction</b>: <span title="Codes:{http://unstats.un.org/unsd/methods/m49/m49.htm 001}">World</span></p><p><b>copyright</b>: </p><div><p>https://creativecommons.org/licenses/by-nc-sa/4.0/</p>
</div><h3>Summaries</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Style</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/ValueSet/citation-summary-style comppub}">Computable Publishing</span></td><td><div><p>Efficacy of Corticosteroids in COVID-19 Patients: A Systematic Review and Meta-Analysis [Preprint], version 1. Contributors: Haytham Tlayjeh, Olaa H. Mhish, Mushira A. Enani, Alya Alruwaili, Rana Tleyjeh, Lukman Thalib, Leslie Hassett, Yaseen M. Arabi, Tarek Kashour, Imad M. Tleyjeh. In: Medrxiv the Preprint Server for the Health Sciences, DOI 10.1101/2020.08.13.20174201. Published August 14, 2020. Accessed March 06, 2021. Available at: https://www.medrxiv.org/content/10.1101/2020.08.13.20174201v1.</p>
</div></td></tr></table><h3>Classifications</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/ValueSet/citation-classification-type fevir-platform-use}">FEvIR Platform Use</span></td><td><span title="Codes:{http://terminology.hl7.org/ValueSet/citation-artifact-classifier project-specific}">Project Specific</span></td></tr></table><p><b>note</b>: </p><blockquote><div><p>Now published in Journal of Infection and Public Health doi: 10.1016/j.jiph.2020.09.008</p>
</div></blockquote><blockquote><p><b>citedArtifact</b></p><p><b>identifier</b>: <code>https://doi.org</code>/10.1101/2020.08.13.20174201, <code>https://www.medrxiv.org/content</code>/10.1101/2020.08.13.20174201v1</p><p><b>dateAccessed</b>: 2021-03-06</p><h3>Titles</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/title-type primary}">Primary title</span></td><td><div><p>Efficacy of Corticosteroids in COVID-19 Patients: A Systematic Review and Meta-Analysis</p>
</div></td></tr></table><h3>Abstracts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-abstract-type primary-human-use}">Primary human use</span></td><td><div><p>Background: To systematically review the literature about the effect of systemic corticosteroid\ntherapy (CST) on outcomes of COVID-19 patients.\nMethods: We searched Medline, Embase, EBM Reviews, Scopus, Web of Science, and preprints\nup to July 20, 2020. We included observational studies and randomized controlled trials (RCT)\nthat assessed COVID-19 patients treated with CST. We pooled adjusted effect estimates of\nmortality and other outcomes using a random effect model, among studies at low or moderate\nrisk for bias. We assessed the certainty of evidence for each outcome using the GRADE\napproach.\nResults: Out of 1067 citations screened for eligibility, one RCT and 19 cohort studies were\nincluded (16,977 hospitalized patients). Ten studies (1 RCT and 9 cohorts) with 10,278 patients\nexamined the effect of CST on short term mortality. The pooled adjusted RR was 0.92 (95% CI\n0.69-1.22, I2\n=81.94 %). This effect was observed across all stages of disease severity. Four\ncohort studies examined the effect of CST on composite outcome of death, ICU admission and\nmechanical ventilation need. The pooled adjusted RR was 0.41(0.23-0.73, I2\n=78.69%). Six\ncohort studies examined the effect of CST on delayed viral clearance. The pooled adjusted RR\nwas 1.47(95% CI 1.11-1.93, I2\n=43.38%).\nConclusion: Heterogeneous and low certainty cumulative evidence suggests that CST lacks\nefficacy in reducing short-term mortality while possibly delaying viral clearance in patients\nhospitalized with COVID-19. Because of the discordant results between the single RCT and\nobservational studies, more research should continue to identify the clinical and biochemical\ncharacteristics of patients’ population that could benefit from CST.</p>
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</div></blockquote><blockquote><p><b>webLocation</b></p><p><b>classifier</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/artifact-url-classifier abstract}">Abstract</span></p><p><b>url</b>: <a href="https://www.medrxiv.org/content/10.1101/2020.08.13.20174201v1">https://www.medrxiv.org/content/10.1101/2020.08.13.20174201v1</a></p></blockquote><blockquote><p><b>webLocation</b></p><p><b>classifier</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/artifact-url-classifier pdf}">PDF</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/artifact-url-classifier full-text}">Full-Text</span></p><p><b>url</b>: <a href="https://www.medrxiv.org/content/10.1101/2020.08.13.20174201v1.full.pdf">https://www.medrxiv.org/content/10.1101/2020.08.13.20174201v1.full.pdf</a></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:">Steroids SMR project use</span></p><p><b>classifier</b>: <span title="Codes:">Excluded supporting information</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type knowledge-artifact-type}">Knowledge Artifact Type</span></p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D000076942}">Preprint</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:">Funding</span></p><p><b>classifier</b>: <span title="Codes:">No funding</span></p></blockquote><blockquote><p><b>contributorship</b></p><p><b>complete</b>: false</p><h3>Entries</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Contributor</b></td><td><b>ForenameInitials</b></td><td><b>Affiliation</b></td><td><b>Role</b></td><td><b>CorrespondingContact</b></td></tr><tr><td style="display: none">*</td><td>Imad M. Tleyjeh Tleyjeh.Imad@mayo.edu</td><td>IM</td><td>College of Medicine, Al Faisal University, Riyadh, Saudi Arabia</td><td><span title="Codes:{http://terminology.hl7.org/ValueSet/contributor-role author}">Author/Creator</span></td><td>true</td></tr></table><h3>Summaries</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Source</b></td><td><b>Value</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/contributor-summary-type author-string}">Author string</span></td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/contributor-summary-source article-copy}">Copied from article</span></td><td><div><p>Haytham Tlayjeh, Olaa H. Mhish, Mushira A. Enani, Alya Alruwaili, Rana Tleyjeh, Lukman Thalib, Leslie Hassett, Yaseen M. Arabi, Tarek Kashour, Imad M. Tleyjeh</p>
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