---
type: "example"
title: "ArtifactAssessment Example: artifactassessment-example-certainty-rating"
resource: "ArtifactAssessment"
example: "artifactassessment-example-certainty-rating"
---
# ArtifactAssessment Example: artifactassessment-example-certainty-rating

## Example XML



```xml
<?xml version="1.0" encoding="UTF-8"?>
<ArtifactAssessment xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../schema/artifactassessment.xsd">
    <id value="example-certainty-rating"/>
    <identifier>
        <type>
            <text value="FEvIR Object Identifier"/>
        </type>
        <system value="https://fevir.net"/>
        <value value="27756"/>
        <assigner>
            <display value="Computable Publishing LLC"/>
        </assigner>
    </identifier>
    <artifactReference>
        <reference value="Evidence/example-stroke-alteplase-fatalICH"/>
        <type value="Evidence"/>
        <display value="Critically appraised summary of all-cause mortality in meta-analysis of RCTs of heparin for moderately ill patients with COVID-19"/>
    </artifactReference>
    <date value="2021-11-02T14:48:59.890Z"/>
    <copyright value="https://creativecommons.org/licenses/by-nc-sa/4.0/"/>
    <content>
        <summary value="serious concerns with risk of bias, inconsistency, and imprecision"/>
        <type>
            <coding>
                <system value="http://hl7.org/fhir/certainty-type"/>
                <code value="Overall"/>
                <display value="Overall certainty"/>
            </coding>
        </type>
        <classifier>
            <coding>
                <system value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
                <code value="very-low"/>
                <display value="Very low quality"/>
            </coding>
        </classifier>
        <author>
            <display value="Brian S. Alper"/>
        </author>
        <freeToShare value="true"/>
        <component>
            <summary value="risk of bias in both included trials"/>
            <type>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/certainty-type"/>
                    <code value="RiskOfBias"/>
                    <display value="Risk of bias"/>
                </coding>
            </type>
            <classifier>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
                    <code value="serious-concern"/>
                    <display value="serious concern"/>
                </coding>
            </classifier>
            <author>
                <display value="Brian S. Alper"/>
            </author>
        </component>
        <component>
            <summary value="high degree of heterogeneity (I-squared 80.7%) with confidence intervals of 2 trial effect estimates barely overlapping"/>
            <type>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/certainty-type"/>
                    <code value="Inconsistency"/>
                    <display value="Inconsistency"/>
                </coding>
            </type>
            <classifier>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
                    <code value="serious-concern"/>
                    <display value="serious concern"/>
                </coding>
            </classifier>
            <author>
                <display value="Brian S. Alper"/>
            </author>
        </component>
        <component>
            <type>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/certainty-type"/>
                    <code value="Indirectness"/>
                    <display value="Indirectness"/>
                </coding>
            </type>
            <classifier>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
                    <code value="no-concern"/>
                    <display value="no serious concern"/>
                </coding>
            </classifier>
            <author>
                <display value="Brian S. Alper"/>
            </author>
        </component>
        <component>
            <summary value="95% confidence interval includes both large effects and no effects"/>
            <type>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/certainty-type"/>
                    <code value="Imprecision"/>
                    <display value="Imprecision"/>
                </coding>
            </type>
            <classifier>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
                    <code value="serious-concern"/>
                    <display value="serious concern"/>
                </coding>
            </classifier>
            <author>
                <display value="Brian S. Alper"/>
            </author>
        </component>
        <component>
            <type>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/certainty-type"/>
                    <code value="PublicationBias"/>
                    <display value="Publication bias"/>
                </coding>
            </type>
            <classifier>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/certainty-rating"/>
                    <code value="no-concern"/>
                    <display value="no serious concern"/>
                </coding>
            </classifier>
            <author>
                <display value="Brian S. Alper"/>
            </author>
        </component>
    </content>
</ArtifactAssessment>
```