Clinical Practice Guidelines (CPG) on EBMonFHIR
1.0.2 - qa-preview

This page is part of the CPG-on-EBMonFHIR Implementation Guide (1.0.2).

Example Bundle: COVID19 Intensive Care Treatment Guideline

Generated Narrative: Bundle COVID19IntensiveCareTreatmentGuidelineBundle

Bundle COVID19IntensiveCareTreatmentGuidelineBundle of type collection


Entry 1 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/guideline

Resource Composition:

Generated Narrative: Composition COVID19IntensiveCareTreatmentGuideline

identifier: Resource identifier/113-001

version: 7.0

status: Final

type: Guidelines

category: Evidence- and consensus-based guideline

date: 2022-03-01

author: Organization Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) e.V.

title: Empfehlungen zur stationären Therapie von Patienten mit COVID-19 - Living Guideline

RelatesTos

-TypeResourceReference
*CitationCitation COVID19_Intensive_Care_Treatment_Guideline

Entry 2 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/guideline-citation

Resource Citation:

Generated Narrative: Citation COVID19IntensiveCareTreatmentGuidelineCitation

name: COVID19_Intensive_Care_Treatment_Guideline

status: Active

citedArtifact

identifier: https://www.awmf.org//113-001

Versions

-Value
*7.0

currentState: Active

Titles

-Text
*

S3-Leitlinie Stationäre Therapie von COVID-19 Patienten

WebLocations

-Url
*https://www.awmf.org/leitlinien/detail/ll/113-001.html

Classifications

-TypeClassifier
*Publication TypeClinical practice guideline

Entry 3 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/dexamethasone/recommendation

Resource PlanDefinition:

Generated Narrative: PlanDefinition COVID19DexamethasoneApplication

knowledgeCapability: computable

knowledgeRepresentationLevel: structured

Action Combination Method

  • method: One or More

url: PlanDefinition Dexamethasone Application

version: 4.0

name: Dexamethasone_Application

title: Dexamethasone Application

type: Workflow Definition

status: Active

experimental: true

subject: Population_COVID19_Ventilated

date: 2021-12-12

publisher: CPGonEBMonFHIR

description:

Application of Dexamethasone for ventilated patients only

RelatedArtifacts

-TypeClassifierResourceReference
*JustificationRecommendation ratingArtifactAssessment: extension = v4.0,active; date = 2020-01-03; artifact[x] = ->PlanDefinition Dexamethasone Application in ventilated COVID-19 patients
*CitationClinical practice guideline recommendationCitation DexamethasoneRecommendationCitation
*CitationClinical practice guidelineCitation COVID19_Intensive_Care_Treatment_Guideline

action

title: Dexamethasone Application

description:

Application of Dexamethasone: 6 mg once per day for 10 days p.o. or i.v. for ventilated COVID-19 patients

code: Guideline-based Care

definition: Dexamethasone Application in ventilated COVID-19 patients

action

title: No Dexamethasone Application

description:

No Dexamethasone Application for non-ventilated COVID-19 patients

code: Guideline-based Care

definition: No Dexamethasone Application for non-ventilated COVID-19 patients


Entry 4 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/dexamethasone/recommendation-plan-ventilated-patients

Resource PlanDefinition:

Generated Narrative: PlanDefinition COVID19VentilatedPatientsDexamethasoneApplicationPlan

knowledgeCapability: computable

knowledgeRepresentationLevel: structured

partOf: Dexamethasone Application

Action Combination Method

  • method: Exactly
  • threshold: 1

url: PlanDefinition Dexamethasone Application in ventilated COVID-19 patients

version: 4.0

name: Dexamethasone_Application

title: Dexamethasone Application in ventilated COVID-19 patients

type: ECA Rule

status: Active

experimental: true

subject: Population_COVID19_Ventilated

date: 2021-12-12

publisher: CPGonEBMonFHIR

description:

Application of Dexamethasone: 6 mg once per day for 10 days p.o. or i.v. for ventilated COVID-19 patients

action

code: Administration of substance (procedure)

definition: DexamethasoneApplicationActionOral

action

code: Administration of substance (procedure)

definition: DexamethasoneApplicationActionIntravenous


Entry 5 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/dexamethasone/recommendation-plan-non-ventilated-patients

Resource PlanDefinition:

Generated Narrative: PlanDefinition COVID19NonVentilatedPatientsDexamethasoneApplicationPlan

knowledgeCapability: computable

knowledgeRepresentationLevel: structured

partOf: Dexamethasone Application

Action Combination Method

  • method: Exactly
  • threshold: 1

url: PlanDefinition No Dexamethasone Application for non-ventilated COVID-19 patients

version: 4.0

name: No_Dexamethasone_Application

title: No Dexamethasone Application for non-ventilated COVID-19 patients

type: ECA Rule

status: Active

experimental: true

subject: Population_COVID19_NonVentilated

date: 2021-12-12

publisher: CPGonEBMonFHIR

description:

No Dexamethasone Application for non-ventilated COVID19 patients

Actions

-CodeDefinition[x]
*Administration of substance (procedure)NoDexamethasoneApplicationActivity

Entry 6 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/dexamethasone/recommendation-action-oral

Resource ActivityDefinition:

Generated Narrative: ActivityDefinition DexamethasoneApplicationActionOral

knowledgeCapability: computable

knowledgeRepresentationLevel: structured

url: ActivityDefinition DexamethasoneApplicationActionOral

version: 1.0

name: DexamethasoneApplicationActionOral

status: Active

experimental: true

subject: Patient

publisher: CPGonEBMonFHIR

description:

Application of Dexamethasone: 6 mg once per day for 10 days (oral route)

kind: MedicationRequest

code: Administration of substance (procedure)

product: Dexamethasone (substance)

dosage

timing: Count 10 times, Duration 10days , Once per 1 days

route: Oral route

DoseAndRates

-Dose[x]Rate[x]
*6 mg (Details: UCUM codemg = 'mg')1 /d (Details: UCUM code/d = '/d')

Entry 7 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/dexamethasone/recommendation-action-intravenous

Resource ActivityDefinition:

Generated Narrative: ActivityDefinition DexamethasoneApplicationActionIntravenous

knowledgeCapability: computable

knowledgeRepresentationLevel: structured

url: ActivityDefinition DexamethasoneApplicationActionIntravenous

version: 1.0

name: DexamethasoneApplicationActionIntravenous

status: Active

experimental: true

subject: Patient

publisher: CPGonEBMonFHIR

description:

Application of Dexamethasone: 6 mg once per day for 10 days (intravenous route)

kind: MedicationRequest

code: Administration of substance (procedure)

product: Dexamethasone (substance)

dosage

timing: Count 10 times, Duration 10days , Once per 1 days

route: Intravenous route

DoseAndRates

-Dose[x]Rate[x]
*6 mg (Details: UCUM codemg = 'mg')1 /d (Details: UCUM code/d = '/d')

Entry 8 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/dexamethasone/recommendation-action-no-application

Resource ActivityDefinition:

Generated Narrative: ActivityDefinition NoDexamethasoneApplication

knowledgeCapability: computable

knowledgeRepresentationLevel: structured

url: ActivityDefinition NoDexamethasoneApplicationActivity

version: 1.0

name: NoDexamethasoneApplicationActivity

status: Active

experimental: true

subject: Patient

publisher: CPGonEBMonFHIR

description:

No Application of Dexamethasone

kind: MedicationRequest

code: Administration of substance (procedure)

doNotPerform: true

product: Dexamethasone (substance)


Entry 9 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/dexamethasone/recommendation-citation

Resource Citation:

Generated Narrative: Citation DexamethasoneRecommendationCitation

name: DexamethasoneRecommendationCitation

status: Active

citedArtifact

identifier: https://api.magicapp.org/api/v1/recommendations/98398

Versions

-Value
*v4.0

currentState: Active

Titles

-Text
*

Steroide

Classifications

-TypeClassifier
*Publication TypeClinical practice guideline recommendation

Entry 10 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/evidence-variable-ventilated

Resource EvidenceVariable:

Generated Narrative: EvidenceVariable PopulationCOVID19Ventilated

url: EvidenceVariable Population_COVID19_Ventilated

identifier: https://www.ceosys.de/Ventilated

name: Population_COVID19_Ventilated

status: Active

description:

Population for guideline from https://app.magicapp.org/#/guidelines / 5691 with characteristics: COVID-19, Ventilated

characteristic

linkId: covid19

DefinitionByTypeAndValues

-TypeValue[x]
*Clinical finding (finding)Disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder)

characteristic

exclude: false

definitionByCombination

code: Any of

characteristic

linkId: oxy-administration-nasal-cannula

exclude: false

DefinitionByTypeAndValues

-TypeValue[x]
*Procedure (procedure)Oxygen administration by nasal cannula (procedure)

TimeFromEvents

-Event[x]Quantity
*covid190 d (Details: UCUM coded = 'd')

characteristic

linkId: noninvasive-ventilation

exclude: false

DefinitionByTypeAndValues

-TypeValue[x]
*Procedure (procedure)Non-invasive ventilation (regime/therapy)

TimeFromEvents

-Event[x]Quantity
*covid190 d (Details: UCUM coded = 'd')

characteristic

linkId: artificial-respiration

exclude: false

DefinitionByTypeAndValues

-TypeValue[x]
*Procedure (procedure)Artificial ventilation (regime/therapy)

TimeFromEvents

-Event[x]Quantity
*covid190 d (Details: UCUM coded = 'd')

Entry 11 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/evidence-variable-non-ventilated

Resource EvidenceVariable:

Generated Narrative: EvidenceVariable PopulationCOVID19NonVentilated

url: EvidenceVariable Population_COVID19_NonVentilated

identifier: https://www.ceosys.de/NonVentilated

name: Population_COVID19_NonVentilated

status: Active

description:

Population for guideline from https://app.magicapp.org/#/guidelines / 5691 with characteristics: COVID-19, not ventilated

characteristic

linkId: covid19

exclude: false

DefinitionByTypeAndValues

-TypeValue[x]
*Clinical finding (finding)Disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder)

characteristic

exclude: true

definitionByCombination

code: Any of

characteristic

linkId: oxy-administration-nasal-cannula

exclude: false

DefinitionByTypeAndValues

-TypeValue[x]
*Procedure (procedure)Oxygen administration by nasal cannula (procedure)

TimeFromEvents

-Event[x]Quantity
*covid190 d (Details: UCUM coded = 'd')

characteristic

linkId: noninvasive-ventilation

exclude: false

DefinitionByTypeAndValues

-TypeValue[x]
*Procedure (procedure)Non-invasive ventilation (regime/therapy)

TimeFromEvents

-Event[x]Quantity
*covid190 d (Details: UCUM coded = 'd')

characteristic

linkId: artificial-respiration

exclude: false

DefinitionByTypeAndValues

-TypeValue[x]
*Procedure (procedure)Artificial ventilation (regime/therapy)

TimeFromEvents

-Event[x]Quantity
*covid190 d (Details: UCUM coded = 'd')

Entry 12 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/dexamethasone/rating-outcome-mortality

Resource ArtifactAssessment:

Generated Narrative: ArtifactAssessment DexamethasoneRatingOutcomeMortality

ArtifactAssessment Version: v4.0

ArtifactAssessment Publication Status: active

date: 2020-01-03

artifact: Evidence ExampleOutcomeEvidence

content

informationType: Rating

type: Overall certainty

classifier: Moderate quality

content

informationType: Rating

type: Clinical Importance

classifier: Critical

content

informationType: Rating

type: Risk of bias

classifier: serious concern

content

informationType: Rating

type: Inconsistency

classifier: no serious concern

content

informationType: Rating

type: Indirectness

classifier: no serious concern

content

informationType: Rating

type: Imprecision

classifier: no serious concern

content

informationType: Rating

type: Publication bias

classifier: no serious concern


Entry 13 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/dexamethasone/outcome-mortality

Resource Evidence:

Generated Narrative: Evidence DexamethasoneOutcomeMortality

name: ExampleOutcomeEvidence

status: Active

RelatedArtifacts

-TypeResourceReference
*CitationCitation SystemicCorticosteroidsForTheTreatmentOfCOVID19

variableDefinition

variableRole: population

observed: Group StudyCohortCriteriaSystemicCorticosteroidsCOVID19

intended: EvidenceVariable StudyEligibilityCriteriaSystemicCorticosteroidsCOVID19

variableDefinition

variableRole: measured variable

observed: EvidenceVariable AllCauseMortality

synthesisType: not applicable

statistic

description:

Relative effect of intervention vs. comparator

statisticType: Relative Risk

quantity: 0.89

SampleSizes

-NumberOfStudiesNumberOfParticipants
*97930

AttributeEstimates

-TypeLevelRange
*Confidence interval0.950.8-1

statistic

description:

Baseline risk/result in the comparison group

statisticType: Incidence

quantity: 245 1/1000 (Details: UCUM code1/1000 = '1/1000')


Entry 14 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/dexamethasone/study-eligibility-criteria

Resource EvidenceVariable:

Generated Narrative: EvidenceVariable StudyEligibilityCriteriaSystemicCorticosteroidsCOVID19

name: StudyEligibilityCriteriaSystemicCorticosteroidsCOVID19

status: Active

characteristic

DefinitionByTypeAndValues

-TypeValue[x]
*Clinical finding (finding)Disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder)

Entry 15 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/outcome-all-cause-mortality

Resource EvidenceVariable:

Generated Narrative: EvidenceVariable OutcomeAllCauseMortality

name: AllCauseMortality

status: Active

Characteristics

-ExcludeDefinitionCodeableConcept
*falseMortality rate (observable entity)

handling: dichotomous variable


Entry 16 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/dexamethasone/recommendation-justification

Resource ArtifactAssessment:

Generated Narrative: ArtifactAssessment DexamethasoneRecommendationJustification

ArtifactAssessment Version: v4.0

ArtifactAssessment Publication Status: active

date: 2020-01-03

artifact: PlanDefinition Dexamethasone Application in ventilated COVID-19 patients

content

informationType: Rating

type: Strength of recommendation

classifier: Strong for an intervention

content

informationType: Rating

type: Consensus

classifier: Strong

content

informationType: Rating

type: Preference and values

classifier: Factor not considered

content

informationType: Rating

type: Resources

classifier: No important issues

content

informationType: Rating

type: Acceptability

classifier: Factor not considered

content

informationType: Rating

type: Feasibility

classifier: Factor not considered

content

informationType: Container

type: Certainty of evidence rating

RelatedArtifacts

-TypeClassifierResourceReference
*JustificationCertainty of evidence ratingArtifactAssessment: extension = v4.0,active; date = 2020-01-03; artifact[x] = ->Evidence ExampleOutcomeEvidence

Entry 17 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/covid19-intensive-care-treatment/dexamethasone/study-citation

Resource Citation:

Generated Narrative: Citation SystemicCorticosteroidsForTheTreatmentOfCOVID19

name: SystemicCorticosteroidsForTheTreatmentOfCOVID19

status: Active

citedArtifact

identifier: https://pubmed.ncbi.nlm.nih.gov/34396514, https://doi.org/10.1002/14651858.CD014963, https://www.ncbi.nlm.nih.gov/pmc//PMC8406706

Titles

-Text
*

Systemic corticosteroids for the treatment of COVID-19

Classifications

-TypeClassifier
*Publication TypeJournal Article