FHIR IG analytics| Package | hl7.fhir.uv.ebm |
| Resource Type | Composition |
| Id | Composition-178426.json |
| FHIR Version | R6 |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Composition 178426
version: 113; Last updated: 2025-10-11 10:37:06+0000; Language: en
Profile: ComparativeEvidenceReportExpanded
Artifact Description:
This example of a ComparativeEvidenceReport Profile shows a report from a single observational study with 2 baseline measures, 2 participant flow measures, and 4 outcome measures.
ArtifactPublicationStatus: Active
url: https://fevir.net/resources/Composition/178426
identifier: FEvIR Object Identifier/178426
status: Final
type: Comparative Evidence Report
date: 2025-10-11 10:37:06+0000
author:
title: ComparativeEvidenceReport: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort)
custodian: Computable Publishing LLC
relatesTo
type: Cite As
target:
ComparativeEvidenceReport: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort) [Database Entry: FHIR Composition Resource]. Contributors: Brian S. Alper, Khalid Shahin, Joanne Dehnbostel [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 178426. Revised 2025-10-11. Available at: https://fevir.net/resources/Composition/178426. Computable resource at: https://fevir.net/resources/Composition/178426#json.
relatesTo
type: Derived From
FHIR
FHIRsmith{
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"language": "en",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
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"valueMarkdown": "This example of a ComparativeEvidenceReport Profile shows a report from a single observational study with 2 baseline measures, 2 participant flow measures, and 4 outcome measures."
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"text": "FEvIR Object Identifier"
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"coding": [
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"system": "https://fevir.net/resources/CodeSystem/179423",
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"text": "Comparative Evidence Report"
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"subject": [
{
"reference": "Group/179633",
"type": "Group",
"display": "ComparativeEvidenceReportSubject: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort)"
}
],
"date": "2025-10-11T10:37:06.099Z",
"author": [
{
"type": "Practitioner",
"display": "Brian S. Alper"
},
{
"type": "Practitioner",
"display": "Khalid Shahin"
},
{
"type": "Practitioner",
"display": "Joanne Dehnbostel"
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],
"title": "ComparativeEvidenceReport: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort)",
"custodian": {
"reference": "Organization/118079",
"type": "Organization",
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"targetMarkdown": "ComparativeEvidenceReport: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort) [Database Entry: FHIR Composition Resource]. Contributors: Brian S. Alper, Khalid Shahin, Joanne Dehnbostel [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 178426. Revised 2025-10-11. Available at: https://fevir.net/resources/Composition/178426. Computable resource at: https://fevir.net/resources/Composition/178426#json."
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"display": "JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort"
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],
"section": [
{
"title": "Introduction",
"code": {
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"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">[No data.]</div>"
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"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><b>StudyGroup: Severely Obese Adults 2018 Norwegian Cohort</b> Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (nā=ā2109) with severe obesity assessed (221 patients excluded and 1888 patients included). (1888 participants)</div>"
},
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{
"reference": "Group/178427",
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}
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},
{
"title": "Intervention Group",
"code": {
"coding": [
{
"system": "https://fevir.net/resources/CodeSystem/179423",
"code": "intervention-group",
"display": "Intervention Group"
}
],
"text": "Intervention Group"
},
"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">932 patients opted for bariatric surgery</div>"
},
"entry": [
{
"reference": "Group/172934",
"type": "Group",
"display": "InterventionGroup: JAMA 2018 Norwegian cohort study Surgery cohort"
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"title": "Intervention Description",
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"coding": [
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"system": "https://fevir.net/resources/CodeSystem/179423",
"code": "intervention-description",
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"text": "Intervention Description"
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"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Bariatric surgery, mostly gastric bypass (92%) or sleeve gastrectomy (7%)</div>"
},
"entry": [
{
"reference": "Group/172423",
"type": "Group",
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}
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},
{
"title": "Comparator Group",
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"coding": [
{
"system": "https://fevir.net/resources/CodeSystem/179423",
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"display": "Comparator Group"
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],
"text": "Comparator Group"
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"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">956 opted for medical management without surgery</div>"
},
"entry": [
{
"reference": "Group/172939",
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}
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"title": "Comparator Description",
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"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">medical treatment without surgery</div>"
},
"entry": [
{
"reference": "Group/172424",
"type": "Group",
"display": "ComparatorDefinition: NOT Bariatric Surgery (RYGB, VSG, LAGB, BPD)"
}
]
},
{
"title": "Group Assignment (EvidenceVariable) Section",
"code": {
"coding": [
{
"system": "https://fevir.net/resources/CodeSystem/179423",
"code": "GroupAssignment",
"display": "GroupAssignment"
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},
"text": {
"status": "empty",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>[No data.]</p></div>"
},
"entry": [
{
"reference": "EvidenceVariable/312202",
"type": "EvidenceVariable",
"display": "GroupAssignment: ExposureDefinition: Bariatric Surgery (RYGB, VSG, LAGB, BPD) vs. ComparatorDefinition: NOT Bariatric Surgery (RYGB, VSG, LAGB, BPD)"
}
]
}
]
},
{
"title": "Research Study",
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"code": "research-study",
"display": "Research Study"
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"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Title:</b> Norwegian Cohort Study Comparing Bariatric Surgery vs Medical Obesity Treatment for Long-term Medical Complications and Obesity-Related Comorbidities</p>\n<p><b>Description:</b> The main purpose of this study is, in combination with data from the Register and Biobank study and follow-up data from the Norwegian Prescription Database, to compare the long-term effects (4-10 years) of surgical and non-surgical treatment of morbid obesity on obesity\n related comorbidities by studying changes in medicine usage after treatment.\n\n Hypotheses\n 1. Primary hypothesis: As compared to non-surgical treatment, bariatric surgery will be associated with higher rates of remission, and lower rates of new-onset drug treated hypertension during a follow-up period of ā¤ 10 years.\n 2. Secondary hypotheses: Changes in the usage of other drugs, particularly drugs related to obesity related comorbidities, will differ significantly between patients undergoing bariatric surgery or non-surgical treatment during the follow-up period. </p>\n<p><b>Study Design:</b> Observational research (coded as: SEVCO:01002 from https://fevir.net/sevco); Parallel cohort design (coded as: SEVCO:01011 from https://fevir.net/sevco); Longitudinal data collection (coded as: SEVCO:01028 from https://fevir.net/sevco)</p></div>"
},
"entry": [
{
"reference": "ResearchStudy/208285",
"type": "ResearchStudy",
"display": "Norwegian Cohort Study Comparing Bariatric Surgery vs Medical Obesity Treatment for Long-term Medical Complications and Obesity-Related Comorbidities"
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{
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"display": "Methods"
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{
"title": "Baseline Measures",
"code": {
"coding": [
{
"system": "https://fevir.net/resources/CodeSystem/179423",
"code": "baseline-measures",
"display": "Baseline Measures"
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],
"text": "Baseline Measures"
},
"text": {
"status": "empty",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>[No data.]</p></div>"
},
"entry": [
{
"reference": "List/312201",
"type": "List",
"display": "BaselineVariablesList: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort)"
}
]
},
{
"title": "Baseline Characteristics",
"code": {
"coding": [
{
"system": "https://fevir.net/resources/CodeSystem/179423",
"code": "baseline-characteristics",
"display": "Baseline Characteristics"
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},
"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>As compared with medical patients, surgically treated patients were significantly younger with a higher BMI. Mean age 41.2 in Surgical Group vs. 45.7 in Medical Group (p < 0.001). Mean BMI 45.4 in Surgical Group vs. 42.9 in Medical Group (p < 0.001).</p></div>"
},
"entry": [
{
"reference": "Composition/312203",
"type": "Composition",
"display": "Baseline Measure Report: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort) (312203)"
}
]
},
{
"title": "Participant Flow",
"code": {
"coding": [
{
"system": "https://fevir.net/resources/CodeSystem/179423",
"code": "participant-flow",
"display": "Participant Flow"
}
],
"text": "Participant Flow"
},
"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">2109 patients included in baseline registry, 221 patients excluded, 1888 patients included in analysis (932 had opted for bariatric surgery, 956 had opted for medical treatment)</div>"
}
},
{
"title": "Outcomes",
"code": {
"coding": [
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"system": "https://fevir.net/resources/CodeSystem/179423",
"code": "outcome-measures",
"display": "Outcome Measures"
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],
"text": "Outcomes"
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"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>emission of diabetes </p><p/>\n<p>New onset depression </p>\n<p> Treatment with opioids</p>\n<p>Additional GI surgical procedure</p></div>"
},
"entry": [
{
"reference": "List/312205",
"type": "List",
"display": "OutcomeVariablesList: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort)"
}
]
},
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"title": "Outcome Findings",
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"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Risk of Remission of diabetes in control group was 14.8%. Risk of Remission of diabetes in intervention group was 57.5%. Greater likelihood of diabetes remission: AR, 57.5% vs 14.8%; RD, 42.7% [95% CI, 35.8%-49.7%], RR, 3.9 [95% CI, 2.8-5.4]</p><p>Compared with specialized medical treatment, bariatric surgery appears to induce remission of diabetes.</p><p>Risk of New onset depression in control group was 6.5%. Risk of New onset depression in intervention group was 8.9%. Greater risk of new-onset depression: AR, 8.9% vs 6.5%; RD, 2.4% [95% CI, 1.3%-3.5%], RR, 1.5 [95% CI, 1.4-1.7].</p><p>Compared with specialized medical treatment, bariatric surgery may slightly increase the incidence of depression.</p><p>Risk of Treatment with opioids in control group was 15.8%. Risk of Treatment with opioids in intervention group was 19.4%. Greater risk of treatment with opioids: AR, 19.4% vs 15.8%, RD, 3.6% [95% CI, 2.3%-4.9%], RR, 1.3 [95% CI, 1.2-1.4].</p><p>Compared with specialized medical treatment, bariatric surgery may slightly increase the use of opioids.</p><p>Risk of additional GI surgical procedure in control group was 15.5%. Risk of additional GI surgical procedure in intervention group was 31.3%. Surgical patients had a greater risk for undergoing at least 1 additional gastrointestinal surgical procedure (AR, 31.3% vs 15.5%; RD, 15.8% [95% CI, 13.1%-18.5%]; RR, 2.0 [95% CI, 1.7-2.4]).</p><p>Compared with specialized medical treatment, bariatric surgery appears to increase the rate of additional gastrointestinal surgical procedures.</p></div>"
},
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{
"reference": "Composition/318262",
"type": "Composition",
"display": "Outcome Measure Report: Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities (2018 Norwegian Cohort) (318262)"
}
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"title": "Discussion Section",
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