Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot3 - STU 1 Ballot 3 World

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

: NetEffectContribution for ComparativeEvidence: Bypass surgery effects on Myocardial infarction or stroke in Swedish Obese Subjects (SOS) study

Page standards status: Informative

Raw json | Download

{
  "resourceType" : "Evidence",
  "id" : "179587",
  "meta" : {
    "versionId" : "13",
    "lastUpdated" : "2026-01-07T11:26:17.820Z",
    "profile" : [
      🔗 "http://hl7.org/fhir/uv/ebm/StructureDefinition/net-effect-contribution"
    ]
  },
  "language" : "en",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Evidence 179587</b></p><a name=\"179587\"> </a><a name=\"hc179587\"> </a><div style=\"display: inline-block; background-color: #fbffeb; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: 13; Last updated: 2026-01-07 11:26:17+0000</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-net-effect-contribution.html\">NetEffectContribution</a></p></div><p><b>url</b>: <a href=\"Evidence-179587.html\">Evidence NetEffectContribution for ComparativeEvidence: Bypass surgery effects on Myocardial infarction or stroke in Swedish Obese Subjects (SOS) study</a></p><p><b>identifier</b>: FEvIR Object Identifier/179587, <a href=\"http://terminology.hl7.org/7.5.0/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 \r\n\r\nThis 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: \r\n\r\nNote 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.\r\n\r\nThis OID may also be used in CD.codeSystem.\">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.4.642.40.44.22.213</p><p><b>version</b>: 1.0.0-ballot3</p><p><b>name</b>: NetEffectContribution_for_ComparativeEvidence_Bypass_surgery_effects_on_Myocardial_infarction_or_stroke_in_Swedish_Obese_Subjects_SOS_study</p><p><b>title</b>: NetEffectContribution for ComparativeEvidence: Bypass surgery effects on Myocardial infarction or stroke in Swedish Obese Subjects (SOS) study</p><p><b>citeAs</b>: </p><div><p>NetEffectContribution for ComparativeEvidence: Bypass surgery effects on Myocardial infarction or stroke in Swedish Obese Subjects (SOS) study [Database Entry: FHIR Evidence Resource]. Contributors: Computable Publishing: Net Effect Generator, Brian S. Alper, MD, MSPH [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 179587. Revised 2026-01-07. Available at: https://fevir.net/resources/Evidence/179587. Computable resource at: https://fevir.net/resources/Evidence/179587#json.</p>\n</div><p><b>status</b>: Active</p><p><b>date</b>: 2026-11-05 14:34:28+0000</p><p><b>author</b>: Computable Publishing: Net Effect Generator: , Brian S. Alper, MD, MSPH: </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>copyright</b>: </p><div><p>https://creativecommons.org/licenses/by-nc-sa/4.0/</p>\n</div><p><b>description</b>: </p><div><p>This Evidence Resource is referenced in an example for the EBMonFHIR Implementation Guide.</p>\n</div><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: </p><div><p>Inclusion criteria were age 37 to 60 years and a body mass index of at least 34 in men and at least 38 in women.  All in Sweden.</p>\n</div><p><b>variableRole</b>: Population</p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: </p><div><p>bariatric surgery vs. usual care without bariatric surgery</p>\n</div><p><b>variableRole</b>: Exposure</p><p><b>comparatorCategory</b>: no bariatric surgery</p><p><b>intended</b>: <a href=\"EvidenceVariable-172427.html\">GroupAssignment: Bariatric Surgery vs. no bariatric surgery</a></p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>description</b>: </p><div><p>nonfatal myocardial infarction or stroke</p>\n</div><p><b>variableRole</b>: Outcome</p><p><b>observed</b>: <a href=\"EvidenceVariable-104097.html\">OutcomeVariable: Nonfatal myocardial infarction or stroke</a></p></blockquote><blockquote><p><b>variableDefinition</b></p><p><b>RelativeOutcomeImportance</b>: <a href=\"ArtifactAssessment-423310.html\">Outcome Importance Rating of DichotomousIntendedOutcome: Nonfatal myocardial infarction or stroke  for StudyEligibilityCriteria: Eligibility Criteria for Bariatric Surgery Randomized Trial (Diabetes Surgery Study)</a></p><p><b>variableRole</b>: Covariate</p><p><b>roleSubtype</b>: <span title=\"Codes:\">Relative Value Multiplier</span></p><p><b>observed</b>: Relative Importance Multiplier</p></blockquote><blockquote><p><b>statistic</b></p><p><b>statisticType</b>: <span title=\"Codes:{https://fevir.net/sevco STATO:0000424}\">risk difference</span></p><p><b>quantity</b>: 151.8</p><h3>AttributeEstimates</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Level</b></td><td><b>Range</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://fevir.net/sevco STATO:0000196}\">confidence interval</span></td><td>0.95</td><td>78.2-211.6</td></tr></table><h3>ModelCharacteristics</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">Net effect contribution analysis</span></td></tr></table></blockquote></div>"
  },
  "url" : "https://fevir.net/resources/Evidence/179587",
  "identifier" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "ACSN",
            "display" : "Accession ID"
          }
        ],
        "text" : "FEvIR Object Identifier"
      },
      "system" : "https://fevir.net/FOI",
      "value" : "179587",
      "assigner" : {
        "display" : "Computable Publishing LLC"
      }
    },
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.40.44.22.213"
    }
  ],
  "version" : "1.0.0-ballot3",
  "name" : "NetEffectContribution_for_ComparativeEvidence_Bypass_surgery_effects_on_Myocardial_infarction_or_stroke_in_Swedish_Obese_Subjects_SOS_study",
  "title" : "NetEffectContribution for ComparativeEvidence: Bypass surgery effects on Myocardial infarction or stroke in Swedish Obese Subjects (SOS) study",
  "citeAs" : "NetEffectContribution for ComparativeEvidence: Bypass surgery effects on Myocardial infarction or stroke in Swedish Obese Subjects (SOS) study [Database Entry: FHIR Evidence Resource]. Contributors: Computable Publishing: Net Effect Generator, Brian S. Alper, MD, MSPH [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 179587. Revised 2026-01-07. Available at: https://fevir.net/resources/Evidence/179587. Computable resource at: https://fevir.net/resources/Evidence/179587#json.",
  "status" : "active",
  "date" : "2026-11-05T14:34:28+00:00",
  "author" : [
    {
      "name" : "Computable Publishing: Net Effect Generator"
    },
    {
      "name" : "Brian S. Alper, MD, MSPH"
    }
  ],
  "publisher" : "HL7 International / Clinical Decision Support",
  "contact" : [
    {
      "name" : "HL7 International / Clinical Decision Support",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/dss"
        }
      ]
    }
  ],
  "copyright" : "https://creativecommons.org/licenses/by-nc-sa/4.0/",
  "description" : "This Evidence Resource is referenced in an example for the EBMonFHIR Implementation Guide.",
  "variableDefinition" : [
    {
      "description" : "Inclusion criteria were age 37 to 60 years and a body mass index of at least 34 in men and at least 38 in women.  All in Sweden.",
      "variableRole" : "population"
    },
    {
      "description" : "bariatric surgery vs. usual care without bariatric surgery",
      "variableRole" : "exposure",
      "comparatorCategory" : "no bariatric surgery",
      "intended" : {
        🔗 "reference" : "EvidenceVariable/172427",
        "type" : "EvidenceVariable",
        "display" : "GroupAssignment: Bariatric Surgery vs. no bariatric surgery"
      }
    },
    {
      "description" : "nonfatal myocardial infarction or stroke",
      "variableRole" : "outcome",
      "observed" : {
        🔗 "reference" : "EvidenceVariable/104097",
        "type" : "EvidenceVariable",
        "display" : "OutcomeVariable: Nonfatal myocardial infarction or stroke"
      }
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/uv/ebm/StructureDefinition/relative-outcome-importance",
          "valueReference" : {
            🔗 "reference" : "ArtifactAssessment/423310",
            "type" : "ArtifactAssessment",
            "display" : "Outcome Importance Rating of DichotomousIntendedOutcome: Nonfatal myocardial infarction or stroke  for StudyEligibilityCriteria: Eligibility Criteria for Bariatric Surgery Randomized Trial (Diabetes Surgery Study)"
          }
        }
      ],
      "variableRole" : "covariate",
      "roleSubtype" : {
        "text" : "Relative Value Multiplier"
      },
      "observed" : {
        "display" : "Relative Importance Multiplier"
      }
    }
  ],
  "statistic" : [
    {
      "statisticType" : {
        "coding" : [
          {
            "system" : "https://fevir.net/sevco",
            "code" : "STATO:0000424",
            "display" : "risk difference"
          }
        ]
      },
      "quantity" : {
        "value" : 151.8
      },
      "attributeEstimate" : [
        {
          "type" : {
            "coding" : [
              {
                "system" : "https://fevir.net/sevco",
                "code" : "STATO:0000196",
                "display" : "confidence interval"
              }
            ]
          },
          "level" : 0.95,
          "range" : {
            "low" : {
              "value" : 78.2
            },
            "high" : {
              "value" : 211.6
            }
          }
        }
      ],
      "modelCharacteristic" : [
        {
          "code" : {
            "text" : "Net effect contribution analysis"
          }
        }
      ]
    }
  ]
}