{
"description": "estimate for all-cause mortality without bariatric surgery 4.75% based on median control event rate in 26 cohort studies with post-bariatric surgery patients and obese controls",
"_filename": "example/Evidence-104384.json",
"package_name": "hl7.fhir.uv.ebm",
"statistic": [ {
"quantity": {
"value": 0.0475
},
"sampleSize": {
"numberOfStudies": 26
},
"description": "median pooled rate 4.75% (range 1.4% to 28.2%) among 26 studies with control event rates",
"statisticType": {
"coding": [ {
"code": "C44256",
"system": "http://terminology.hl7.org/CodeSystem/statistic-type",
"display": "Proportion",
"version": "5.0.0-cibuild"
} ]
},
"attributeEstimate": [ {
"type": {
"coding": [ {
"code": "C38013",
"system": "http://terminology.hl7.org/CodeSystem/attribute-estimate-type",
"display": "Range",
"version": "5.0.0-cibuild"
} ]
},
"range": {
"low": {
"value": 0.014
},
"high": {
"value": 0.282
}
},
"description": "range 1.4% to 28.2%"
} ],
"modelCharacteristic": [ {
"code": {
"text": "median value of proportions",
"coding": [ {
"code": "defined-in-text",
"system": "https://fevir.net/resources/CodeSystem/179423",
"display": "Defined in text"
} ]
}
} ]
} ],
"date": "2022-09-19T21:15:10.416Z",
"meta": {
"profile": [ "http://hl7.org/fhir/uv/ebm/StructureDefinition/comparator-only-evidence", "http://hl7.org/fhir/uv/ebm/StructureDefinition/evidence-synthesis-evidence" ],
"versionId": "13",
"lastUpdated": "2023-12-03T10:00:31.851Z"
},
"publisher": "HL7 International / Clinical Decision Support",
"name": "AllCauseMortalityControlGroup2022metaAnalysis",
"copyright": "https://creativecommons.org/licenses/by-nc-sa/4.0/",
"type": null,
"experimental": null,
"resourceType": "Evidence",
"variableDefinition": [ {
"note": [ {
"text": "population"
} ],
"intended": {
"type": "Group",
"display": "ComparatorGroup: Obese patients ≥ 18 years old without bariatric surgery",
"reference": "Group/172460"
},
"extension": [ {
"url": "http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code",
"valueCode": "population"
} ],
"description": "obese, adult (age ≥18 years old) patients who had No weight-loss surgical intervention *NOTE: note.text is used artificially to support the EBMonFHIR Implementation Guide and the following content would more properly be found in a note.text element:* Studies were considered eligible if they were designed to study outcomes in obese patients who underwent a weight-loss surgical intervention in comparison with an age, sex, and BMI matched control group who did not undergo a weight-loss surgical intervention. We searched for randomized controlled trials, prospective or retrospective longitudinal cohort studies, and case–control studies. For the control group, all non-surgical treatment options for obesity (e.g. intensive lifestyle intervention, standard of care, or no specific therapy) were accepted. Studies were excluded if (i) patients were not matched for age, sex, and BMI; (ii) the presence of one or more outcome parameters of interest (e.g. HF, AF, coronary artery disease) was required for inclusion; or (iii) if study groups were not representative in relation to the general population of patients with obesity (e.g. patients could only be included in the presence of a specific comorbidity, for instance, end-stage renal disease). The third criterium did not apply to Type 2 diabetes, thus studies that only included patients with Type 2 diabetes could be eligible for inclusion. As the control group (observed reference exposure) was defined differently in each study, the intended reference exposure is described as the absence of the intended exposure (Bariatric Surgery).",
"variableRole": {
"text": "Use extension:variableRoleCode instead.",
"coding": [ {
"code": "population",
"system": "http://terminology.hl7.org/CodeSystem/variable-role",
"display": "population"
} ]
}
}, {
"note": [ {
"text": "outcome"
} ],
"intended": {
"type": "EvidenceVariable",
"display": "OutcomeVariable: All-cause mortality",
"reference": "EvidenceVariable/49217"
},
"observed": {
"display": "We searched for randomized controlled trials, prospective or retrospective longitudinal cohort studies, and case–control studies. For the control group, all non-surgical treatment options for obesity (e.g. intensive lifestyle intervention, standard of care, or no specific therapy) were accepted. Studies were excluded if (i) patients were not matched for age, sex, and BMI; (ii) the presence of one or more outcome parameters of interest (e.g. HF, AF, coronary artery disease) was required for inclusion; or (iii) if study groups were not representative in relation to the general population of patients with obesity (e.g. patients could only be included in the presence of a specific comorbidity, for instance, end-stage renal disease). The third criterium did not apply to Type 2 diabetes, thus studies that only included patients with Type 2 diabetes could be eligible for inclusion."
},
"extension": [ {
"url": "http://hl7.org/fhir/uv/ebm/StructureDefinition/variable-definition-variable-role-code",
"valueCode": "outcome"
} ],
"description": "All-cause mortality *NOTE: note.text is used artificially to support the EBMonFHIR Implementation Guide and the following content would more properly be found in a note.text element:* The observed element can reference an EvidenceVariable Resource that defines the outcome measured through structured characteristics. For example, 'Mean difference in HbA1c at 12 months' or 'Mean difference in HbA1c at end of study'. The structured characteristics can be references to the Evidence instances for each of the included studies, in which case this is a direct link to the dataset used for analysis. The intended element can reference an EvidenceVariable Resource that expresses the outcome intended for evidence application through structured characteristics. The structured characteristics could be used to express the SR eligibility criteria for study outcomes (as a subset of eligibility criteria for studies).",
"variableRole": {
"text": "Use extension:variableRoleCode instead.",
"coding": [ {
"code": "measuredVariable",
"system": "http://terminology.hl7.org/CodeSystem/variable-role",
"display": "measured variable"
} ]
}
} ],
"title": "ComparatorOnlyEvidence: All-cause mortality without bariatric surgery in 2022 meta-analysis",
"package_version": "1.0.0-ballot",
"author": [ {
"name": "Brian S. Alper"
} ],
"synthesisType": {
"text": "median of pooled rates",
"coding": [ {
"code": "pooled",
"system": "http://terminology.hl7.org/CodeSystem/synthesis-type",
"display": "pooled rates"
} ]
},
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "cds"
} ],
"status": "active",
"id": "c4f54bb9-8dbe-427b-9997-7a8bd105acdf",
"kind": null,
"url": "https://fevir.net/resources/Evidence/104384",
"identifier": [ {
"type": {
"text": "FEvIR Object Identifier",
"coding": [ {
"code": "ACSN",
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"display": "Accession ID"
} ]
},
"value": "104384",
"system": "https://fevir.net",
"assigner": {
"display": "Computable Publishing LLC"
}
} ],
"version": "1.0.0-ballot",
"relatedArtifact": [ {
"type": "derived-from",
"label": "data source",
"citation": "Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis [Journal Article]. Contributors: van Veldhuisen SL, Gorter TM, van Woerden G, de Boer RA, Rienstra M, Hazebroek EJ, van Veldhuisen DJ. In: European heart journal, PMID 35243488. Published March 04, 2022. Available at: https://pubmed.ncbi.nlm.nih.gov/35243488/.",
"document": {
"url": "https://academic.oup.com/eurheartj/article/43/20/1955/6542137"
}
}, {
"type": "supported-with",
"display": "Citation Resource for 2022 Systematic Review of bariatric surgery mortality effect - PMID 35243488",
"classifier": [ {
"text": "Citation Resource for the original article"
} ],
"resourceReference": {
"type": "Citation",
"display": "StudyCitation: 2022 Systematic Review of bariatric surgery mortality effect 35243488",
"reference": "Citation/33400"
}
}, {
"type": "cite-as",
"citation": "ComparatorOnlyEvidence: All-cause mortality without bariatric surgery in 2022 meta-analysis [Evidence]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 104384. Revised 2022-09-19. Available at: https://fevir.net/resources/Evidence/104384. Computable resource at: https://fevir.net/resources/Evidence/104384."
} ],
"studyDesign": [ {
"coding": [ {
"code": "SEVCO:01002",
"system": "http://hl7.org/fhir/study-design",
"display": "Observational research",
"version": "5.0.0-cibuild"
} ]
}, {
"coding": [ {
"code": "SEVCO:01011",
"system": "http://hl7.org/fhir/study-design",
"display": "Parallel cohort design",
"version": "5.0.0-cibuild"
} ]
}, {
"coding": [ {
"code": "SEVCO:01014",
"system": "http://hl7.org/fhir/study-design",
"display": "Matching for comparison",
"version": "5.0.0-cibuild"
} ]
} ],
"contact": [ {
"name": "HL7 International / Clinical Decision Support",
"telecom": [ {
"value": "http://www.hl7.org/Special/committees/dss",
"system": "url"
} ]
} ]
}