Generated Narrative: Citation 7638 version: 39; Last updated: 2025-10-13 16:59:33+0000 ArtifactPublicationStatus: Active url: Citation Citation for FEvIR Evidence 7637: Critically appraised summary of primary outcome of multi-platform RCT of anticoagulation for non-critically ill COVID-19 identifier: FEvIR Object Identifier/7638, <a href="http://terminology.hl7.org/7.0.1/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 #xD;#xA;#xD;#xA;This oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid: #xD;#xA;#xD;#xA;Note that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.#xD;#xA;#xD;#xA;This OID may also be used in CD.codeSystem.">Uniform Resource Identifier (URI)/urn:oid:2.16.840.1.113883.4.642.40.44.15.19 version: 1.0.0-ballot3 title: Citation for FEvIR Evidence 7637: Critically appraised summary of primary outcome of multi-platform RCT of anticoagulation for non-critically ill COVID-19 status: Active date: 2022-01-10 13:30:43+0000 author: Brian S. Alper: publisher: HL7 International / Clinical Decision Support contact: HL7 International / Clinical Decision Support: http://www.hl7.org/Special/committees/dss description: A Evidence Resource to demonstrate complex evidence reporting UseContexts - Code Value[x] * UsageContextType: program (Program) EBMonFHIR/COKA Demonstration * Citation Classification Type: fevir-platform-use (FEvIR Platform Use) Evidence jurisdiction: World copyright: https://creativecommons.org/licenses/by-nc-sa/4.0/ Summaries - Style Text * Computable Publishing Critically appraised summary of primary outcome of multi-platform RCT of anticoagulation for non-critically ill patients with COVID-19 [FHIR Resource]. Contributors: Brian S Alper, Harold Lehmann, Ahmad Sofi-Mahmudi, Joanne Dehnbostel, Ilkka Kunnamo [Authors]; Janice Tufte, Vignesh Subbian, Bhagvan Kommadi, Alfonso Iorio, Muhammad Afzal, Kenneth J Wilkins, Surbhi Shah, Amy Price [Reviewers]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 7637. Published August 05, 2021. Created August 05, 2021. Revised August 25, 2021. Available at: https://fevir.net/resources/Evidence/7637. Computable resource at: https://fevir.net/resources/Evidence/7637. Classifications - Type Classifier * FEvIR Platform Use Project Specific citedArtifact identifier: FEvIR Object Identifier/7637 relatedIdentifier: https://doi.org/10.1056/NEJMoa2105911 StatusDates - Activity Actual Period * Created true 2021-08-05 --> (ongoing) title type: Primary title, Human use text: Critically appraised summary of primary outcome of multi-platform RCT of anticoagulation for non-critically ill patients with COVID-19 title type: Different text in an earlier version text: Critically appraised summary of primary outcome of multi-platform RCT of anticoagulation for non-critically ill COVID-19 abstract type: Description text: Patients who were hospitalized for COVID-19 and who were not critically ill were randomized in a response-adaptive manner to therapeutic-dose anticoagulation with heparin vs. usual-care pharmacologic thromboprophylaxis. The outcome reported here is the effect on organ support-free days (i.e. days without oxygen delivered by high-flow nasal cannula, noninvasive or invasive mechanical ventilation, or the use of vasopressors or inotropes). The statistical result was a median adjusted odds ratio 1.27 (95% credible interval 1.03 to 1.58), based on 1,740 events among 2,219 participants with known outcome out of 2,244 enrolled participants. The probability of superiority of therapeutic-dose anticoagulation with heparin was 98.6%. The risk of bias in this effect estimate is of extremely serious concern based on a serious concern for confounding covariate bias (confounding difference in calendar time), a very serious concern for performance bias (inadequate blinding of intervention deliverers who may determine the outcome based in part on exposure status), and very serious concern for analysis bias (bias related to selection of the analysis, and early trial termination). abstract type: Assertion text: It is uncertain whether therapeutic-dose anticoagulation with heparin affects the rate of organ support-free days in hospitalized patients with COVID-19 who are not critically ill. RelatesTos - Type Classifier Citation * Cites Journal Article Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19 [Journal Article]. Contributors: The ATTACC, ACTIV-4a, and REMAP-CAP Investigators. In: The New England Journal of Medicine, DOI 10.1056/NEJMoa2105911. Published August 04, 2021. Available at: https://doi.org/10.1056/NEJMoa2105911. publicationForm PublishedIns - Type Title Publisher PublisherLocation * Database Fast Evidence Interoperability Resources (FEvIR) Platform Computable Publishing LLC Franklin, NC, USA articleDate: 2021-08-05 lastRevisionDate: 2021-08-25 copyright: https://creativecommons.org/licenses/by-nc-sa/4.0/ webLocation classifier: Computable resource, JSON url: https://fevir.net/resources/Evidence/7637 classification type: Knowledge Artifact Type classifier: FHIR Resource classification type: fhir-resource classifier: Evidence contributorship complete: true entry contributor: Practitioner Brian S Alper forenameInitials: BS affiliation: Computable Publishing LLC Scientific Knowledge Accelerator Foundation COVID-19 Knowledge Accelerator contributionType: Conceptualization, Data curation, Investigation, Methodology, Software, Writing - original draft role: Author/Creator ContributionInstances - Type Time * defined-in-text 2021-08-05 correspondingContact: true entry contributor: Practitioner Janice Tufte affiliation: Hassanah Consulting contributionType: Writing - review & editing, Formal analysis, Investigation, Validation role: Reviewer contributionInstance type: Reviewed time: 2021-08-05 contributionInstance type: Reviewed time: 2021-08-06 entry contributor: Practitioner Harold Lehmann affiliation: Johns Hopkins University contributionType: Investigation, Methodology, Writing - original draft role: Author/Creator entry contributor: Practitioner Ahmad Sofi-Mahmudi affiliation: Cochrane Iran Associate Centre contributionType: Investigation, Methodology, Validation, Writing - review & editing role: Author/Creator entry contributor: Practitioner Joanne Dehnbostel affiliation: Computable Publishing LLC contributionType: Project administration, Investigation, Writing - review & editing role: Author/Creator entry contributor: Practitioner Vignesh Subbian affiliation: University of Arizona contributionType: Formal analysis, Investigation, Writing - review & editing role: Reviewer ContributionInstances - Type Time * Reviewed 2021-08-07 entry contributor: Practitioner Ilkka Kunnamo affiliation: Duodecim Medical Publications Ltd., Finland Scientific Knowledge Accelerator Foundation contributionType: Writing - review & editing role: Author/Creator ContributionInstances - Type Time * Reviewed 2021-08-09 entry contributor: Practitioner Bhagvan Kommadi affiliation: Value Momentum contributionType: Methodology, Validation role: Reviewer entry contributor: Practitioner Alfonso Iorio affiliation: McMaster University contributionType: Formal analysis, Writing - review & editing role: Reviewer entry contributor: Practitioner Muhammad Afzal affiliation: Sejong University, Seoul, South Korea contributionType: Formal analysis, Writing - review & editing role: Reviewer entry contributor: Practitioner Kenneth J Wilkins affiliation: National Institute of Diabetes & Digestive & Kidney Diseases contributionType: Formal analysis, Writing - review & editing role: Reviewer entry contributor: Practitioner Surbhi Shah affiliation: Mayo Clinic Arizona contributionType: Writing - review & editing, defined-in-text role: Reviewer entry contributor: Practitioner Amy Price contributionType: Writing - review & editing role: Reviewer Generated Narrative: Practitioner #contributor0 identifier: https://orcid.org//0000-0003-4300-4928 name: Brian S Alper telecom: balper@computablepublishing.com Generated Narrative: Practitioner #contributor1 identifier: https://orcid.org//0000-0002-4346-3238 name: Janice Tufte telecom: hassanahseattle@gmail.com Generated Narrative: Practitioner #contributor2 name: Harold Lehmann telecom: lehmann@jhmi.edu Generated Narrative: Practitioner #contributor3 name: Ahmad Sofi-Mahmudi telecom: a.sofimahmudi@gmail.com Generated Narrative: Practitioner #contributor4 name: Joanne Dehnbostel telecom: jdehnbostel@computablepublishing.com Generated Narrative: Practitioner #contributor5 name: Vignesh Subbian telecom: vsubbian@arizona.edu Generated Narrative: Practitioner #contributor6 identifier: https://orcid.org//0000-0002-4817-6991 name: Ilkka Kunnamo telecom: ilkka.kunnamo@duodecim.fi Generated Narrative: Practitioner #contributor7 name: Bhagvan Kommadi telecom: bhagvanarch@gmail.com Generated Narrative: Practitioner #contributor8 name: Alfonso Iorio Generated Narrative: Practitioner #contributor9 name: Muhammad Afzal telecom: afzalse@gmail.com Generated Narrative: Practitioner #contributor10 name: Kenneth J Wilkins Generated Narrative: Practitioner #contributor11 name: Surbhi Shah Generated Narrative: Practitioner #contributor12 name: Amy Price
Citation for FEvIR Evidence 7637: Critically appraised summary of primary outcome of multi-platform RCT of anticoagulation for non-critically ill COVID-19
HL7 International / Clinical Decision Support
A Evidence Resource to demonstrate complex evidence reporting
Critically appraised summary of primary outcome of multi-platform RCT of anticoagulation for non-critically ill patients with COVID-19 [FHIR Resource]. Contributors: Brian S Alper, Harold Lehmann, Ahmad Sofi-Mahmudi, Joanne Dehnbostel, Ilkka Kunnamo [Authors]; Janice Tufte, Vignesh Subbian, Bhagvan Kommadi, Alfonso Iorio, Muhammad Afzal, Kenneth J Wilkins, Surbhi Shah, Amy Price [Reviewers]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 7637. Published August 05, 2021. Created August 05, 2021. Revised August 25, 2021. Available at: https://fevir.net/resources/Evidence/7637. Computable resource at: https://fevir.net/resources/Evidence/7637.
Critically appraised summary of primary outcome of multi-platform RCT of anticoagulation for non-critically ill patients with COVID-19
Critically appraised summary of primary outcome of multi-platform RCT of anticoagulation for non-critically ill COVID-19
Patients who were hospitalized for COVID-19 and who were not critically ill were randomized in a response-adaptive manner to therapeutic-dose anticoagulation with heparin vs. usual-care pharmacologic thromboprophylaxis. The outcome reported here is the effect on organ support-free days (i.e. days without oxygen delivered by high-flow nasal cannula, noninvasive or invasive mechanical ventilation, or the use of vasopressors or inotropes). The statistical result was a median adjusted odds ratio 1.27 (95% credible interval 1.03 to 1.58), based on 1,740 events among 2,219 participants with known outcome out of 2,244 enrolled participants. The probability of superiority of therapeutic-dose anticoagulation with heparin was 98.6%. The risk of bias in this effect estimate is of extremely serious concern based on a serious concern for confounding covariate bias (confounding difference in calendar time), a very serious concern for performance bias (inadequate blinding of intervention deliverers who may determine the outcome based in part on exposure status), and very serious concern for analysis bias (bias related to selection of the analysis, and early trial termination).
It is uncertain whether therapeutic-dose anticoagulation with heparin affects the rate of organ support-free days in hospitalized patients with COVID-19 who are not critically ill.
Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19 [Journal Article]. Contributors: The ATTACC, ACTIV-4a, and REMAP-CAP Investigators. In: The New England Journal of Medicine, DOI 10.1056/NEJMoa2105911. Published August 04, 2021. Available at: https://doi.org/10.1056/NEJMoa2105911.
Fast Evidence Interoperability Resources (FEvIR) Platform
Scientific Knowledge Accelerator Foundation
Duodecim Medical Publications Ltd., Finland
National Institute of Diabetes & Digestive & Kidney Diseases