Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot3 - STU 1 ballot
Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot3 - 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-ballot3 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
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"lastUpdated" : "2026-06-07T15:45:00.875Z"
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"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Citation 111</b></p><a name=\"111\"> </a><a name=\"hc111\"> </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: 15; Last updated: 2026-06-07 15:45:00+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=\"https://fevir.net/resources/Citation/111\">https://fevir.net/resources/Citation/111</a></p><p><b>identifier</b>: FEvIR Object Identifier/111</p><p><b>title</b>: SMR-excluded Tlayjeh H J Infect Public Health 33008778</p><p><b>status</b>: Active</p><p><b>date</b>: 2021-09-24 12:05:20+0000</p><p><b>author</b>: Brian S. Alper: </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>description</b>: </p><div><p>A systematic review included in the Steroids SMR Project</p>\n</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/7.1.0/CodeSystem-usage-context-type.html#usage-context-type-program\">UsageContextType: program</a> (Program)</td><td><span title=\"Codes:\">Steroids SMR Project</span></td></tr></table><p><b>copyright</b>: </p><div><p>https://creativecommons.org/licenses/by-nc-sa/4.0/</p>\n</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/CodeSystem/citation-summary-style comppub}\">Computable Publishing</span></td><td><div><p>Association of corticosteroids use and outcomes in COVID-19 patients: A systematic review and meta-analysis [Journal Article]. In: Journal of infection and public health, PMID 33008778. Published September 29, 2020. Available at: https://doi.org/10.1016/j.jiph.2020.09.008.</p>\n</div></td></tr></table><h3>RelatesTos</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Target[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>Derived From</td><td><a href=\"Citation-105.html\">33008778 Medline Base</a></td></tr></table><blockquote><p><b>citedArtifact</b></p><p><b>identifier</b>: <code>https://pubmed.ncbi.nlm.nih.gov</code>/33008778, pii/S1876-0341(20)30663-8, <code>https://doi.org</code>/10.1016/j.jiph.2020.09.008, <code>https://www.ncbi.nlm.nih.gov/pmc/</code>/PMC7522674</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:\">primary-human-use</span></td><td><div><p>Association of corticosteroids use and outcomes in COVID-19 patients: A systematic review and meta-analysis.</p>\n</div></td></tr></table><h3>Abstracts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Text</b></td><td><b>Copyright</b></td></tr><tr><td style=\"display: none\">*</td><td><div><p><strong>BACKGROUND:</strong> To systematically review the literature about the association between systemic corticosteroid therapy (CST) and outcomes of COVID-19 patients.\n<strong>METHODS:</strong> We searched Medline, Embase, EBM Reviews, Scopus, Web of Science, and preprints up to July 20, 2020. We included observational studies and randomized controlled trials (RCT) that assessed COVID-19 patients treated with CST. We pooled adjusted effect estimates of mortality and other outcomes using a random effect model, among studies at low or moderate risk for bias. We assessed the certainty of evidence for each outcome using the GRADE approach.\n<strong>RESULTS:</strong> Out of 1067 citations screened for eligibility, one RCT and 19 cohort studies were included (16,977 hospitalized patients). Ten studies (1 RCT and 9 cohorts) with 10,278 patients examined the effect of CST on short term mortality. The pooled adjusted RR was 0.92 (95% CI 0.69-1.22, I2 = 81.94%). This effect was observed across all stages of disease severity. Four cohort studies examined the effect of CST on composite outcome of death, ICU admission and mechanical ventilation need. The pooled adjusted RR was 0.41(0.23-0.73, I2 = 78.69%). Six cohort studies examined the effect of CST on delayed viral clearance. The pooled adjusted RR was 1.47(95% CI 1.11-1.93, I2 = 43.38%).\n<strong>CONCLUSION:</strong> In this systematic review, as of July 2020, heterogeneous and low certainty cumulative evidence based on observational studies and one RCT suggests that CST was not associated with reduction in short-term mortality but possibly with a delay in viral clearance in patients hospitalized with COVID-19 of different severities. However, the discordant results between the single RCT and observational studies as well as the heterogeneity observed across observational studies, call for caution in using observational data and suggests the need for more RCTs to identify the clinical and biochemical characteristics of patients' population that could benefit from CST.</p>\n</div></td><td><div><p>Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.</p>\n</div></td></tr></table><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>JAMA. 2020 Aug 25;324(8):782-793</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32648899/\">https://pubmed.ncbi.nlm.nih.gov/32648899/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Chest. 2020 Nov;158(5):1876-1884</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32569635/\">https://pubmed.ncbi.nlm.nih.gov/32569635/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Intensive Care Med. 2020 Jun;46(6):1099-1102</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32291463/\">https://pubmed.ncbi.nlm.nih.gov/32291463/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Lancet Infect Dis. 2020 Oct;20(10):1135-1140</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32526193/\">https://pubmed.ncbi.nlm.nih.gov/32526193/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Clin Infect Dis. 2020 Jul 28;71(15):799-806</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32271376/\">https://pubmed.ncbi.nlm.nih.gov/32271376/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Antimicrob Agents Chemother. 2020 Aug 20;64(9):</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32571831/\">https://pubmed.ncbi.nlm.nih.gov/32571831/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Ann Intern Med. 2015 Oct 6;163(7):519-28</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/26258555/\">https://pubmed.ncbi.nlm.nih.gov/26258555/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>BMJ. 2003 Sep 6;327(7414):557-60</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/12958120/\">https://pubmed.ncbi.nlm.nih.gov/12958120/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>J Med Virol. 2020 Jul 9;:</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32644223/\">https://pubmed.ncbi.nlm.nih.gov/32644223/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>J Clin Invest. 2020 May 1;130(5):2620-2629</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32217835/\">https://pubmed.ncbi.nlm.nih.gov/32217835/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Control Clin Trials. 1986 Sep;7(3):177-88</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/3802833/\">https://pubmed.ncbi.nlm.nih.gov/3802833/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>BMJ. 2009 Jul 21;339:b2700</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/19622552/\">https://pubmed.ncbi.nlm.nih.gov/19622552/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Eur J Clin Invest. 2020 Oct;50(10):e13319</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32535894/\">https://pubmed.ncbi.nlm.nih.gov/32535894/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Am J Epidemiol. 2007 Sep 15;166(6):646-55</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/17615092/\">https://pubmed.ncbi.nlm.nih.gov/17615092/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>J Clin Epidemiol. 2010 Feb;63(2):130-5</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/20122499/\">https://pubmed.ncbi.nlm.nih.gov/20122499/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Crit Care. 2020 May 19;24(1):241</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32430057/\">https://pubmed.ncbi.nlm.nih.gov/32430057/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Br J Cancer. 2014 Feb 4;110(3):551-5</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/24495873/\">https://pubmed.ncbi.nlm.nih.gov/24495873/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Lancet. 2020 May 2;395(10234):1417-1418</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32325026/\">https://pubmed.ncbi.nlm.nih.gov/32325026/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Lancet. 2020 Feb 29;395(10225):683-684</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32122468/\">https://pubmed.ncbi.nlm.nih.gov/32122468/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>PLoS Med. 2006 Sep;3(9):e343</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/16968120/\">https://pubmed.ncbi.nlm.nih.gov/16968120/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>N Engl J Med. 2020 Jul 9;383(2):120-128</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32437596/\">https://pubmed.ncbi.nlm.nih.gov/32437596/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>J Allergy Clin Immunol. 2020 Jul;146(1):110-118</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32294485/\">https://pubmed.ncbi.nlm.nih.gov/32294485/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Cochrane Database Syst Rev. 2014 Apr 29;(4):MR000034</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/24782322/\">https://pubmed.ncbi.nlm.nih.gov/24782322/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Lancet Respir Med. 2018 Sep;6(9):691-698</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/30078618/\">https://pubmed.ncbi.nlm.nih.gov/30078618/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>J Clin Epidemiol. 2008 Oct;61(10):991-6</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/18538991/\">https://pubmed.ncbi.nlm.nih.gov/18538991/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Am J Epidemiol. 2007 Nov 15;166(10):1203-9</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/17712019/\">https://pubmed.ncbi.nlm.nih.gov/17712019/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>BMJ. 2016 Oct 12;355:i4919</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/27733354/\">https://pubmed.ncbi.nlm.nih.gov/27733354/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Int J Infect Dis. 2020 Jul;96:531-537</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32425636/\">https://pubmed.ncbi.nlm.nih.gov/32425636/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Mayo Clin Proc. 2017 Mar;92(3):423-433</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/28259229/\">https://pubmed.ncbi.nlm.nih.gov/28259229/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Crit Care. 2019 Mar 27;23(1):99</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/30917856/\">https://pubmed.ncbi.nlm.nih.gov/30917856/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Clin Infect Dis. 2020 Nov 19;71(16):2114-2120</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32427279/\">https://pubmed.ncbi.nlm.nih.gov/32427279/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>PLoS One. 2020 Sep 9;15(9):e0238827</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32903258/\">https://pubmed.ncbi.nlm.nih.gov/32903258/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>J Infect Dis. 2009 Aug 15;200(4):492-500</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/19591575/\">https://pubmed.ncbi.nlm.nih.gov/19591575/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>EClinicalMedicine. 2020 Jun 25;24:100434</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32766543/\">https://pubmed.ncbi.nlm.nih.gov/32766543/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Int J Infect Dis. 2020 Sep;98:252-260</p>\n</div><p><b>target</b>: <a 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href=\"https://pubmed.ncbi.nlm.nih.gov/32548616/\">https://pubmed.ncbi.nlm.nih.gov/32548616/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Crit Care Med. 2009 May;37(5):1594-603</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/19325471/\">https://pubmed.ncbi.nlm.nih.gov/19325471/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Crit Care Med. 2016 Feb;44(2):275-81</p>\n</div><p><b>target</b>: <a 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href=\"https://pubmed.ncbi.nlm.nih.gov/29161116/\">https://pubmed.ncbi.nlm.nih.gov/29161116/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>Clin Immunol. 2020 May;214:108393</p>\n</div><p><b>target</b>: <a href=\"https://pubmed.ncbi.nlm.nih.gov/32222466/\">https://pubmed.ncbi.nlm.nih.gov/32222466/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>citation</b>: </p><div><p>J Clin Epidemiol. 2011 Apr;64(4):383-94</p>\n</div><p><b>target</b>: <a 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true</p><blockquote><p><b>entry</b></p></blockquote><blockquote><p><b>entry</b></p></blockquote><blockquote><p><b>entry</b></p></blockquote><blockquote><p><b>entry</b></p></blockquote><blockquote><p><b>entry</b></p></blockquote><blockquote><p><b>entry</b></p></blockquote><blockquote><p><b>entry</b></p></blockquote><blockquote><p><b>entry</b></p></blockquote><blockquote><p><b>entry</b></p></blockquote><blockquote><p><b>entry</b></p></blockquote></blockquote></blockquote></div>"
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"title" : "SMR-excluded Tlayjeh H J Infect Public Health 33008778",
"status" : "active",
"date" : "2021-09-24T12:05:20.353Z",
"author" : [
{
"name" : "Brian S. Alper"
}
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"text" : "Association of corticosteroids use and outcomes in COVID-19 patients: A systematic review and meta-analysis [Journal Article]. In: Journal of infection and public health, PMID 33008778. Published September 29, 2020. Available at: https://doi.org/10.1016/j.jiph.2020.09.008."
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"text" : "Association of corticosteroids use and outcomes in COVID-19 patients: A systematic review and meta-analysis."
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],
"abstract" : [
{
"text" : "**BACKGROUND:** To systematically review the literature about the association between systemic corticosteroid therapy (CST) and outcomes of COVID-19 patients.\n**METHODS:** We searched Medline, Embase, EBM Reviews, Scopus, Web of Science, and preprints up to July 20, 2020. We included observational studies and randomized controlled trials (RCT) that assessed COVID-19 patients treated with CST. We pooled adjusted effect estimates of mortality and other outcomes using a random effect model, among studies at low or moderate risk for bias. We assessed the certainty of evidence for each outcome using the GRADE approach.\n**RESULTS:** Out of 1067 citations screened for eligibility, one RCT and 19 cohort studies were included (16,977 hospitalized patients). Ten studies (1 RCT and 9 cohorts) with 10,278 patients examined the effect of CST on short term mortality. The pooled adjusted RR was 0.92 (95% CI 0.69-1.22, I2 = 81.94%). This effect was observed across all stages of disease severity. Four cohort studies examined the effect of CST on composite outcome of death, ICU admission and mechanical ventilation need. The pooled adjusted RR was 0.41(0.23-0.73, I2 = 78.69%). Six cohort studies examined the effect of CST on delayed viral clearance. The pooled adjusted RR was 1.47(95% CI 1.11-1.93, I2 = 43.38%).\n**CONCLUSION:** In this systematic review, as of July 2020, heterogeneous and low certainty cumulative evidence based on observational studies and one RCT suggests that CST was not associated with reduction in short-term mortality but possibly with a delay in viral clearance in patients hospitalized with COVID-19 of different severities. However, the discordant results between the single RCT and observational studies as well as the heterogeneity observed across observational studies, call for caution in using observational data and suggests the need for more RCTs to identify the clinical and biochemical characteristics of patients' population that could benefit from CST.",
"copyright" : "Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved."
}
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IG © 2024+ HL7 International / Clinical Decision Support.
Package hl7.fhir.uv.ebm#1.0.0-ballot3 based on FHIR 6.0.0-ballot3.
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2026-06-12
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