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Packagehl7.fhir.uv.ebm
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IdComposition-104215.json
FHIR VersionR6

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Source1

{
  "resourceType": "Composition",
  "id": "104215",
  "meta": {
    "versionId": "36",
    "lastUpdated": "2025-02-26T22:31:07.150Z",
    "profile": [
      "http://hl7.org/fhir/uv/ebm/StructureDefinition/summary-of-findings"
    ]
  },
  "language": "en",
  "text": {
    "status": "empty",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/artifact-description",
      "valueMarkdown": "Example of SummaryOfFindings Profile of Composition Resource."
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/artifact-copyright",
      "valueMarkdown": "https://creativecommons.org/licenses/by-nc-sa/4.0/"
    },
    {
      "url": "http://hl7.org/fhir/uv/ebm/StructureDefinition/artifact-publication-status",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/cited-artifact-status-type",
            "code": "active",
            "display": "Active"
          }
        ]
      }
    }
  ],
  "url": "https://fevir.net/resources/Composition/104215",
  "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": "104215",
      "assigner": {
        "display": "Computable Publishing LLC"
      }
    }
  ],
  "status": "final",
  "type": {
    "coding": [
      {
        "system": "https://fevir.net/resources/CodeSystem/179423",
        "code": "SummaryOfFindings",
        "display": "SummaryOfFindings"
      }
    ],
    "text": "Summary of Findings"
  },
  "subject": [
    {
      "reference": "Group/179562",
      "type": "Group",
      "display": "EvidenceReportSubject: Clinical Outcomes for Effects of Bariatric Surgery"
    }
  ],
  "date": "2025-02-26T22:31:07.150Z",
  "author": [
    {
      "type": "Practitioner",
      "display": "Brian S. Alper"
    }
  ],
  "title": "SummaryOfFindings: Bariatric Surgery Summary of Findings Example for GIN 2022",
  "custodian": {
    "display": "Computable Publishing LLC"
  },
  "relatesTo": [
    {
      "type": "cite-as",
      "targetMarkdown": "SummaryOfFindings: Bariatric Surgery Summary of Findings Example for GIN 2022 [Database Entry: FHIR Composition Resource]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 104215. Revised 2025-02-25. Available at: https://fevir.net/resources/Composition/104215. Computable resource at: https://fevir.net/resources/Composition/104215."
    }
  ],
  "section": [
    {
      "title": "Column Headers",
      "code": {
        "coding": [
          {
            "system": "https://fevir.net/resources/CodeSystem/179423",
            "code": "column-headers",
            "display": "Column Headers"
          }
        ]
      },
      "section": [
        {
          "title": "Outcome",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "outcome-measure",
                "display": "Outcome Measure"
              }
            ]
          },
          "text": {
            "status": "generated",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Outcome</div>"
          }
        },
        {
          "title": "Sample Size",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "sample-size",
                "display": "Sample Size"
              }
            ]
          },
          "text": {
            "status": "generated",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Sample size: # studies, # participants, # counted, # events</div>"
          }
        },
        {
          "title": "Result Without Treatment",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "result-with-comparator-alone",
                "display": "Result with comparator alone"
              }
            ]
          },
          "text": {
            "status": "additional",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Result without bariatric surgery</div>"
          }
        },
        {
          "title": "Result With Treatment--Observed",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "result-with-intervention-alone",
                "display": "Result with intervention alone"
              }
            ]
          },
          "text": {
            "status": "additional",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Result with bariatric surgery</div>"
          }
        },
        {
          "title": "Result With Treatment--Derived",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "result-with-intervention-alone-calculated",
                "display": "Result with intervention alone (calculated)"
              }
            ],
            "text": "calculated value derived from the control group and effect estimate"
          },
          "text": {
            "status": "additional",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Result with bariatric surgery (calculated)</div>"
          }
        },
        {
          "title": "Effect Estimate",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "result-with-intervention-vs-comparator",
                "display": "Result with intervention vs. comparator"
              }
            ]
          },
          "text": {
            "status": "generated",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Effect Estimate (Relative effect)</div>"
          }
        },
        {
          "title": "Certainty of Evidence",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "certainty-of-evidence",
                "display": "Certainty of Evidence"
              }
            ]
          },
          "text": {
            "status": "generated",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Certainty of finding (Quality of evidence)</div>"
          }
        },
        {
          "title": "Assertion",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "assertion",
                "display": "Assertion"
              }
            ]
          },
          "text": {
            "status": "generated",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">What this means</div>"
          }
        }
      ]
    },
    {
      "title": "Summary of Findings",
      "code": {
        "coding": [
          {
            "system": "https://fevir.net/resources/CodeSystem/179423",
            "code": "summary-of-findings",
            "display": "Summary of Findings"
          }
        ]
      },
      "section": [
        {
          "title": "All-cause mortality",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "summary-of-findings-entry-for-a-single-outcome",
                "display": "Summary of findings entry for a single outcome"
              }
            ]
          },
          "focus": {
            "reference": "EvidenceVariable/49217",
            "type": "EvidenceVariable",
            "display": "OutcomeVariable: All-cause mortality"
          },
          "text": {
            "status": "empty",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">[No data.]</div>"
          },
          "section": [
            {
              "title": "Outcome",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "outcome-measure",
                    "display": "Outcome Measure"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">All-cause mortality</div>"
              },
              "entry": [
                {
                  "reference": "EvidenceVariable/49217",
                  "type": "EvidenceVariable",
                  "display": "OutcomeVariable: All-cause mortality"
                }
              ]
            },
            {
              "title": "Sample Size",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "sample-size",
                    "display": "Sample Size"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">21 studies, 397002 participants</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/49328",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: All-cause mortality effect of bariatric surgery in 2022 meta-analysis"
                }
              ]
            },
            {
              "title": "Result Without Treatment",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-comparator-alone",
                    "display": "Result with comparator alone"
                  }
                ]
              },
              "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">5% (estimated); specific summary evidence not reported</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104384",
                  "type": "Evidence",
                  "display": "ComparatorOnlyEvidence: All-cause mortality without bariatric surgery in 2022 meta-analysis"
                }
              ]
            },
            {
              "title": "Result With Treatment--Observed",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-alone",
                    "display": "Result with intervention alone"
                  }
                ]
              },
              "text": {
                "status": "empty",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Not reported</div>"
              }
            },
            {
              "title": "Result With Treatment--Derived",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-alone-calculated",
                    "display": "Result with intervention alone (calculated)"
                  }
                ],
                "text": "calculated value derived from the control group and effect estimate"
              },
              "text": {
                "status": "empty",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Not reported</div>"
              }
            },
            {
              "title": "Effect Estimate",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-vs-comparator",
                    "display": "Result with intervention vs. comparator"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Hazard Ratio 0.55 (95% confidence interval 0.49 to 0.62)</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/49328",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: All-cause mortality effect of bariatric surgery in 2022 meta-analysis"
                }
              ]
            },
            {
              "title": "Certainty of Evidence",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "certainty-of-evidence",
                    "display": "Certainty of Evidence"
                  }
                ]
              },
              "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Low quality</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/49328",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: All-cause mortality effect of bariatric surgery in 2022 meta-analysis"
                }
              ]
            },
            {
              "title": "Assertion",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "assertion",
                    "display": "Assertion"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">The present systematic review and meta-analysis suggests that bariatric surgery is associated with reduced all-cause and CV mortality.</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/49328",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: All-cause mortality effect of bariatric surgery in 2022 meta-analysis"
                }
              ]
            }
          ]
        },
        {
          "title": "Nonfatal myocardial infarction or stroke",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "summary-of-findings-entry-for-a-single-outcome",
                "display": "Summary of findings entry for a single outcome"
              }
            ]
          },
          "focus": {
            "reference": "EvidenceVariable/104097",
            "type": "EvidenceVariable",
            "display": "OutcomeVariable: Nonfatal myocardial infarction or stroke"
          },
          "text": {
            "status": "empty",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">[No data.]</div>"
          },
          "section": [
            {
              "title": "Outcome",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "outcome-measure",
                    "display": "Outcome Measure"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Nonfatal myocardial infarction or stroke</div>"
              },
              "entry": [
                {
                  "reference": "EvidenceVariable/104097",
                  "type": "EvidenceVariable",
                  "display": "OutcomeVariable: Nonfatal myocardial infarction or stroke"
                }
              ]
            },
            {
              "title": "Sample Size",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "sample-size",
                    "display": "Sample Size"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">1 study, 4,047 participants, 4,047 counted, 359 events</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104098",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Myocardial infarction or stroke in Swedish Obese Subjects (SOS) study"
                }
              ]
            },
            {
              "title": "Result Without Treatment",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-comparator-alone",
                    "display": "Result with comparator alone"
                  }
                ]
              },
              "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">188 out of 2,037 observed with percentage of: 9.2%</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104397",
                  "type": "Evidence",
                  "display": "ComparatorOnlyEvidence: Myocardial infarction or stroke without bariatric surgery (Control Group) in Swedish Obese Subjects (SOS) study"
                }
              ]
            },
            {
              "title": "Result With Treatment--Observed",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-alone",
                    "display": "Result with intervention alone"
                  }
                ]
              },
              "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">171 out of 2,010 observed with percentage of: 8.5%</div>"
              }
            },
            {
              "title": "Result With Treatment--Derived",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-alone-calculated",
                    "display": "Result with intervention alone (calculated)"
                  }
                ],
                "text": "calculated value derived from the control group and effect estimate"
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">6.2%</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104397",
                  "type": "Evidence",
                  "display": "ComparatorOnlyEvidence: Myocardial infarction or stroke without bariatric surgery (Control Group) in Swedish Obese Subjects (SOS) study"
                },
                {
                  "reference": "Evidence/104098",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Myocardial infarction or stroke in Swedish Obese Subjects (SOS) study"
                }
              ]
            },
            {
              "title": "Effect Estimate",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-vs-comparator",
                    "display": "Result with intervention vs. comparator"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Hazard Ratio 0.67 (95% CI  0.54 to 0.83)</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104098",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Myocardial infarction or stroke in Swedish Obese Subjects (SOS) study"
                }
              ]
            },
            {
              "title": "Certainty of Evidence",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "certainty-of-evidence",
                    "display": "Certainty of Evidence"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Low quality</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104098",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Myocardial infarction or stroke in Swedish Obese Subjects (SOS) study"
                }
              ]
            },
            {
              "title": "Assertion",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "assertion",
                    "display": "Assertion"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Compared with usual care, bariatric surgery was associated with reduced number of cardiovascular deaths and lower incidence of cardiovascular events in obese adults.</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104098",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Myocardial infarction or stroke in Swedish Obese Subjects (SOS) study"
                }
              ]
            }
          ]
        },
        {
          "title": "Remission of diabetes",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "summary-of-findings-entry-for-a-single-outcome",
                "display": "Summary of findings entry for a single outcome"
              }
            ]
          },
          "focus": {
            "reference": "EvidenceVariable/104117",
            "type": "EvidenceVariable",
            "display": "OutcomeVariable: Remission of diabetes"
          },
          "text": {
            "status": "empty",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">[No data.]</div>"
          },
          "section": [
            {
              "title": "Outcome",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "outcome-measure",
                    "display": "Outcome Measure"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Remission of diabetes</div>"
              },
              "entry": [
                {
                  "reference": "EvidenceVariable/104117",
                  "type": "EvidenceVariable",
                  "display": "OutcomeVariable: Remission of diabetes"
                }
              ]
            },
            {
              "title": "Sample Size",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "sample-size",
                    "display": "Sample Size"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">1 study, 1,888 participants, 1,888 counted</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104121",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Result Without Treatment",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-comparator-alone",
                    "display": "Result with comparator alone"
                  }
                ]
              },
              "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">141 out of 956 observed with percentage of: 14.8%</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104396",
                  "type": "Evidence",
                  "display": "ComparatorOnlyEvidence: Remission of diabetes without bariatric surgery (Control Group) in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Result With Treatment--Observed",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-alone",
                    "display": "Result with intervention alone"
                  }
                ]
              },
              "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">536 out of 932 observed with percentage of: 57.5%</div>"
              }
            },
            {
              "title": "Result With Treatment--Derived",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-alone-calculated",
                    "display": "Result with intervention alone (calculated)"
                  }
                ],
                "text": "calculated value derived from the control group and effect estimate"
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">57.7%</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104396",
                  "type": "Evidence",
                  "display": "ComparatorOnlyEvidence: Remission of diabetes without bariatric surgery (Control Group) in JAMA 2018 Norwegian cohort study"
                },
                {
                  "reference": "Evidence/104121",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Effect Estimate",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-vs-comparator",
                    "display": "Result with intervention vs. comparator"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Relative Risk 3.9 (95% CI  2.8 to 5.4)</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104121",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Certainty of Evidence",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "certainty-of-evidence",
                    "display": "Certainty of Evidence"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Moderate quality</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104121",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Assertion",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "assertion",
                    "display": "Assertion"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Compared with specialized medical treatment, bariatric surgery appears to induce remission of diabetes.</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104121",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Remission of diabetes in JAMA 2018 Norwegian cohort study"
                }
              ]
            }
          ]
        },
        {
          "title": "New onset depression",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "summary-of-findings-entry-for-a-single-outcome",
                "display": "Summary of findings entry for a single outcome"
              }
            ]
          },
          "focus": {
            "reference": "EvidenceVariable/104118",
            "type": "EvidenceVariable",
            "display": "OutcomeVariable: New onset depression"
          },
          "text": {
            "status": "empty",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">[No data.]</div>"
          },
          "section": [
            {
              "title": "Outcome",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "outcome-measure",
                    "display": "Outcome Measure"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">New onset depression</div>"
              },
              "entry": [
                {
                  "reference": "EvidenceVariable/104118",
                  "type": "EvidenceVariable",
                  "display": "OutcomeVariable: New onset depression"
                }
              ]
            },
            {
              "title": "Sample Size",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "sample-size",
                    "display": "Sample Size"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">1 study, 1,888 participants, 1,888 counted</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104155",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on New onset depression in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Result Without Treatment",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-comparator-alone",
                    "display": "Result with comparator alone"
                  }
                ]
              },
              "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">62 out of 956 observed with percentage of: 6.5%</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104395",
                  "type": "Evidence",
                  "display": "ComparatorOnlyEvidence: New onset depression without bariatric surgery (Control Group) in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Result With Treatment--Observed",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-alone",
                    "display": "Result with intervention alone"
                  }
                ]
              },
              "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">83 out of 932 observed with percentage of: 8.9%</div>"
              }
            },
            {
              "title": "Result With Treatment--Derived",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-alone-calculated",
                    "display": "Result with intervention alone (calculated)"
                  }
                ],
                "text": "calculated value derived from the control group and effect estimate"
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">9.75%</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104395",
                  "type": "Evidence",
                  "display": "ComparatorOnlyEvidence: New onset depression without bariatric surgery (Control Group) in JAMA 2018 Norwegian cohort study"
                },
                {
                  "reference": "Evidence/104155",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on New onset depression in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Effect Estimate",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-vs-comparator",
                    "display": "Result with intervention vs. comparator"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Relative Risk 1.5 (95% CI 1.4 to 1.7)</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104155",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on New onset depression in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Certainty of Evidence",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "certainty-of-evidence",
                    "display": "Certainty of Evidence"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Low quality</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104155",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on New onset depression in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Assertion",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "assertion",
                    "display": "Assertion"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Compared with specialized medical treatment, bariatric surgery may slightly increase the incidence of depression.</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104155",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on New onset depression in JAMA 2018 Norwegian cohort study"
                }
              ]
            }
          ]
        },
        {
          "title": "Treatment with opioids",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "summary-of-findings-entry-for-a-single-outcome",
                "display": "Summary of findings entry for a single outcome"
              }
            ]
          },
          "focus": {
            "reference": "EvidenceVariable/104119",
            "type": "EvidenceVariable",
            "display": "OutcomeVariable: Treatment with opioids"
          },
          "text": {
            "status": "empty",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">[No data.]</div>"
          },
          "section": [
            {
              "title": "Outcome",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "outcome-measure",
                    "display": "Outcome Measure"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Treatment with opioids</div>"
              },
              "entry": [
                {
                  "reference": "EvidenceVariable/104119",
                  "type": "EvidenceVariable",
                  "display": "OutcomeVariable: Treatment with opioids"
                }
              ]
            },
            {
              "title": "Sample Size",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "sample-size",
                    "display": "Sample Size"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">1 study, 1,888 participants, 1,888 counted</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104156",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Treatment with opioids in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Result Without Treatment",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-comparator-alone",
                    "display": "Result with comparator alone"
                  }
                ]
              },
              "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">151 out of 956 observed with percentage of: 15.8%</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104394",
                  "type": "Evidence",
                  "display": "ComparatorOnlyEvidence: Treatment with opioids without bariatric surgery (Control Group) in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Result With Treatment--Observed",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-alone",
                    "display": "Result with intervention alone"
                  }
                ]
              },
              "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">181 out of 932 observed with percentage of: 19.4%</div>"
              }
            },
            {
              "title": "Result With Treatment--Derived",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-alone-calculated",
                    "display": "Result with intervention alone (calculated)"
                  }
                ],
                "text": "calculated value derived from the control group and effect estimate"
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">20.5%</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104394",
                  "type": "Evidence",
                  "display": "ComparatorOnlyEvidence: Treatment with opioids without bariatric surgery (Control Group) in JAMA 2018 Norwegian cohort study"
                },
                {
                  "reference": "Evidence/104156",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Treatment with opioids in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Effect Estimate",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-vs-comparator",
                    "display": "Result with intervention vs. comparator"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Relative Risk 1.3 (95% CI 1.2 to 1.4)</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104156",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Treatment with opioids in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Certainty of Evidence",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "certainty-of-evidence",
                    "display": "Certainty of Evidence"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Low quality</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104156",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Treatment with opioids in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Assertion",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "assertion",
                    "display": "Assertion"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Compared with specialized medical treatment, bariatric surgery may slightly increase the use of opioids.</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104156",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Treatment with opioids in JAMA 2018 Norwegian cohort study"
                }
              ]
            }
          ]
        },
        {
          "title": "Additional GI surgical procedure",
          "code": {
            "coding": [
              {
                "system": "https://fevir.net/resources/CodeSystem/179423",
                "code": "summary-of-findings-entry-for-a-single-outcome",
                "display": "Summary of findings entry for a single outcome"
              }
            ]
          },
          "focus": {
            "reference": "EvidenceVariable/104120",
            "type": "EvidenceVariable",
            "display": "OutcomeVariable: Additional GI surgical procedure"
          },
          "text": {
            "status": "empty",
            "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">[No data.]</div>"
          },
          "section": [
            {
              "title": "Outcome",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "outcome-measure",
                    "display": "Outcome Measure"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Additional GI surgical procedure</div>"
              },
              "entry": [
                {
                  "reference": "EvidenceVariable/104120",
                  "type": "EvidenceVariable",
                  "display": "OutcomeVariable: Additional GI surgical procedure"
                }
              ]
            },
            {
              "title": "Sample Size",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "sample-size",
                    "display": "Sample Size"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">1 study, 1,888 participants, 1,888 counted</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104157",
                  "type": "Evidence",
                  "display": "StudyOutcomeEvidence: Bypass surgery effects on Additional GI surgical procedure in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Result Without Treatment",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-comparator-alone",
                    "display": "Result with comparator alone"
                  }
                ]
              },
              "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">148 out of 956 observed with percentage of: 15.5%</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104385",
                  "type": "Evidence",
                  "display": "ComparatorOnlyEvidence: Additional GI surgical procedure without bariatric surgery (Control Group) in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Result With Treatment--Observed",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-alone",
                    "display": "Result with intervention alone"
                  }
                ]
              },
              "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">292 out of 932 observed with percentage of: 31.3%</div>"
              }
            },
            {
              "title": "Result With Treatment--Derived",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-alone-calculated",
                    "display": "Result with intervention alone (calculated)"
                  }
                ],
                "text": "calculated value derived from the control group and effect estimate"
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">31%</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104385",
                  "type": "Evidence",
                  "display": "ComparatorOnlyEvidence: Additional GI surgical procedure without bariatric surgery (Control Group) in JAMA 2018 Norwegian cohort study"
                },
                {
                  "reference": "Evidence/104157",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Additional GI surgical procedure in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Effect Estimate",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "result-with-intervention-vs-comparator",
                    "display": "Result with intervention vs. comparator"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Relative Risk 2.0 (95% CI 1.7 to 2.4)</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104157",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Additional GI surgical procedure in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Certainty of Evidence",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "certainty-of-evidence",
                    "display": "Certainty of Evidence"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Moderate quality</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104157",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Additional GI surgical procedure in JAMA 2018 Norwegian cohort study"
                }
              ]
            },
            {
              "title": "Assertion",
              "code": {
                "coding": [
                  {
                    "system": "https://fevir.net/resources/CodeSystem/179423",
                    "code": "assertion",
                    "display": "Assertion"
                  }
                ]
              },
              "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Compared with specialized medical treatment, bariatric surgery appears to increase the rate of additional gastrointestinal surgical procedures.</div>"
              },
              "entry": [
                {
                  "reference": "Evidence/104157",
                  "type": "Evidence",
                  "display": "ComparativeEvidence: Bypass surgery effects on Additional GI surgical procedure in JAMA 2018 Norwegian cohort study"
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}