PMC:1084246 / 14795-16303 JSONTXT

{"project":"biosemtest","denotations":[{"id":"T1958","span":{"begin":154,"end":159},"obj":"UMLS/C1706074"},{"id":"T1959","span":{"begin":958,"end":963},"obj":"UMLS/C1706074"},{"id":"T1960","span":{"begin":1198,"end":1203},"obj":"UMLS/C1706074"},{"id":"T1961","span":{"begin":154,"end":159},"obj":"UMLS/C1706073"},{"id":"T1962","span":{"begin":958,"end":963},"obj":"UMLS/C1706073"},{"id":"T1963","span":{"begin":1198,"end":1203},"obj":"UMLS/C1706073"},{"id":"T1964","span":{"begin":1341,"end":1351},"obj":"UMLS/C0022423"},{"id":"T1965","span":{"begin":550,"end":554},"obj":"UMLS/C0445247"},{"id":"T1966","span":{"begin":760,"end":764},"obj":"UMLS/C0445247"},{"id":"T1967","span":{"begin":117,"end":125},"obj":"UMLS/C1551396"},{"id":"T1968","span":{"begin":486,"end":494},"obj":"UMLS/C1551396"},{"id":"T1969","span":{"begin":154,"end":159},"obj":"UMLS/C0039224"},{"id":"T1970","span":{"begin":958,"end":963},"obj":"UMLS/C0039224"},{"id":"T1971","span":{"begin":1198,"end":1203},"obj":"UMLS/C0039224"},{"id":"T1972","span":{"begin":555,"end":564},"obj":"UMLS/C1550715"},{"id":"T1973","span":{"begin":994,"end":1001},"obj":"UMLS/C1707959"},{"id":"T1974","span":{"begin":1335,"end":1340},"obj":"UMLS/C0205088"},{"id":"T1975","span":{"begin":1002,"end":1007},"obj":"UMLS/C1514721"},{"id":"T1976","span":{"begin":1040,"end":1046},"obj":"UMLS/C1514721"},{"id":"T1977","span":{"begin":342,"end":350},"obj":"UMLS/C1883712"},{"id":"T1978","span":{"begin":633,"end":638},"obj":"UMLS/C1880279"},{"id":"T1979","span":{"begin":97,"end":105},"obj":"UMLS/C0332120"},{"id":"T1980","span":{"begin":248,"end":256},"obj":"UMLS/C0332120"},{"id":"T1981","span":{"begin":424,"end":432},"obj":"UMLS/C0332120"},{"id":"T1982","span":{"begin":458,"end":470},"obj":"UMLS/C0332120"},{"id":"T1983","span":{"begin":614,"end":622},"obj":"UMLS/C0332120"},{"id":"T1984","span":{"begin":661,"end":669},"obj":"UMLS/C0332120"},{"id":"T1985","span":{"begin":705,"end":713},"obj":"UMLS/C0332120"},{"id":"T1986","span":{"begin":1373,"end":1381},"obj":"UMLS/C0332120"},{"id":"T1987","span":{"begin":765,"end":771},"obj":"UMLS/C1550456"},{"id":"T1988","span":{"begin":1118,"end":1126},"obj":"UMLS/C0750482"},{"id":"T1989","span":{"begin":388,"end":390},"obj":"UMLS/C0319022"},{"id":"T1990","span":{"begin":1017,"end":1019},"obj":"UMLS/C0319022"},{"id":"T1991","span":{"begin":1054,"end":1056},"obj":"UMLS/C0319022"},{"id":"T1992","span":{"begin":916,"end":926},"obj":"UMLS/C2348149"},{"id":"T1993","span":{"begin":971,"end":977},"obj":"UMLS/C0449788"},{"id":"T1994","span":{"begin":1002,"end":1007},"obj":"UMLS/C2348147"},{"id":"T1995","span":{"begin":1040,"end":1046},"obj":"UMLS/C2348147"},{"id":"T1996","span":{"begin":444,"end":449},"obj":"UMLS/C1548802"},{"id":"T1997","span":{"begin":687,"end":693},"obj":"UMLS/C1548802"},{"id":"T1998","span":{"begin":555,"end":564},"obj":"UMLS/C0700158"},{"id":"T1999","span":{"begin":646,"end":652},"obj":"UMLS/C1522410"},{"id":"T2000","span":{"begin":1183,"end":1189},"obj":"UMLS/C1554112"},{"id":"T2001","span":{"begin":633,"end":638},"obj":"UMLS/C1549548"},{"id":"T2002","span":{"begin":144,"end":152},"obj":"UMLS/C0332147"},{"id":"T2003","span":{"begin":329,"end":337},"obj":"UMLS/C0332147"},{"id":"T2004","span":{"begin":936,"end":944},"obj":"UMLS/C0332147"},{"id":"T2005","span":{"begin":444,"end":449},"obj":"UMLS/C1619811"},{"id":"T2006","span":{"begin":687,"end":693},"obj":"UMLS/C1619811"},{"id":"T2007","span":{"begin":910,"end":915},"obj":"UMLS/C0439099"},{"id":"T2008","span":{"begin":1034,"end":1039},"obj":"UMLS/C0439099"},{"id":"T2009","span":{"begin":1177,"end":1182},"obj":"UMLS/C0439099"},{"id":"T2010","span":{"begin":1211,"end":1216},"obj":"UMLS/C0439099"},{"id":"T2011","span":{"begin":1290,"end":1295},"obj":"UMLS/C0439099"},{"id":"T2012","span":{"begin":169,"end":173},"obj":"UMLS/C1561559"},{"id":"T2013","span":{"begin":169,"end":173},"obj":"UMLS/C1561558"},{"id":"T2014","span":{"begin":971,"end":977},"obj":"UMLS/C1554106"},{"id":"T2015","span":{"begin":1240,"end":1248},"obj":"UMLS/C1552866"},{"id":"T2016","span":{"begin":1183,"end":1189},"obj":"UMLS/C1704610"},{"id":"T2017","span":{"begin":382,"end":387},"obj":"UMLS/C0036658"},{"id":"T2018","span":{"begin":1127,"end":1132},"obj":"UMLS/C0205169"},{"id":"T2019","span":{"begin":444,"end":449},"obj":"UMLS/C1708760"},{"id":"T2020","span":{"begin":687,"end":693},"obj":"UMLS/C1708760"},{"id":"T2021","span":{"begin":633,"end":638},"obj":"UMLS/C1626935"},{"id":"T2022","span":{"begin":916,"end":926},"obj":"UMLS/C0600673"},{"id":"T2023","span":{"begin":471,"end":474},"obj":"UMLS/C0205447"},{"id":"T2024","span":{"begin":1168,"end":1176},"obj":"UMLS/C0205160"},{"id":"T2025","span":{"begin":1168,"end":1176},"obj":"UMLS/C1513916"},{"id":"T2026","span":{"begin":169,"end":173},"obj":"UMLS/C1547310"},{"id":"T2027","span":{"begin":444,"end":449},"obj":"UMLS/C0441994"},{"id":"T2028","span":{"begin":687,"end":693},"obj":"UMLS/C0441994"},{"id":"T2029","span":{"begin":117,"end":125},"obj":"UMLS/C1547308"},{"id":"T2030","span":{"begin":486,"end":494},"obj":"UMLS/C1547308"},{"id":"T2031","span":{"begin":1151,"end":1160},"obj":"UMLS/C1444656"},{"id":"T2032","span":{"begin":1071,"end":1080},"obj":"UMLS/C1550608"},{"id":"T2033","span":{"begin":1013,"end":1016},"obj":"UMLS/C0205448"},{"id":"T2034","span":{"begin":633,"end":638},"obj":"UMLS/C1550601"},{"id":"T2035","span":{"begin":765,"end":771},"obj":"UMLS/C1518601"},{"id":"T2036","span":{"begin":1020,"end":1025},"obj":"UMLS/C0205453"},{"id":"T2037","span":{"begin":1335,"end":1340},"obj":"UMLS/C0444930"},{"id":"T2038","span":{"begin":117,"end":125},"obj":"UMLS/C1579038"},{"id":"T2039","span":{"begin":486,"end":494},"obj":"UMLS/C1579038"},{"id":"T2040","span":{"begin":971,"end":977},"obj":"UMLS/C1709287"},{"id":"T2041","span":{"begin":1127,"end":1132},"obj":"UMLS/C1522166"},{"id":"T2042","span":{"begin":1127,"end":1132},"obj":"UMLS/C1279889"},{"id":"T2043","span":{"begin":1183,"end":1189},"obj":"UMLS/C0042295"},{"id":"T2044","span":{"begin":555,"end":564},"obj":"UMLS/C0522247"},{"id":"T2045","span":{"begin":355,"end":360},"obj":"UMLS/C0037088"},{"id":"T2046","span":{"begin":184,"end":193},"obj":"UMLS/C0558058"},{"id":"T2047","span":{"begin":555,"end":564},"obj":"UMLS/C0439755"},{"id":"T2048","span":{"begin":550,"end":554},"obj":"UMLS/C1692345"},{"id":"T2049","span":{"begin":760,"end":764},"obj":"UMLS/C1692345"},{"id":"T2050","span":{"begin":633,"end":638},"obj":"UMLS/C0178499"},{"id":"T2051","span":{"begin":1141,"end":1147},"obj":"UMLS/C0237506"},{"id":"T2052","span":{"begin":1317,"end":1323},"obj":"UMLS/C0237506"},{"id":"T2053","span":{"begin":646,"end":652},"obj":"UMLS/C1561958"},{"id":"T2054","span":{"begin":646,"end":652},"obj":"UMLS/C1561957"},{"id":"T2055","span":{"begin":117,"end":125},"obj":"UMLS/C1547298"},{"id":"T2056","span":{"begin":486,"end":494},"obj":"UMLS/C1547298"},{"id":"T2057","span":{"begin":633,"end":638},"obj":"UMLS/C1705938"},{"id":"T2058","span":{"begin":58,"end":67},"obj":"UMLS/C0680240"},{"id":"T2059","span":{"begin":174,"end":183},"obj":"UMLS/C0680240"},{"id":"T2060","span":{"begin":1086,"end":1095},"obj":"UMLS/C0680240"},{"id":"T2061","span":{"begin":1300,"end":1309},"obj":"UMLS/C0680240"},{"id":"T2062","span":{"begin":213,"end":226},"obj":"UMLS/C0680238"},{"id":"T2063","span":{"begin":8,"end":15},"obj":"UMLS/C0332306"},{"id":"T2064","span":{"begin":86,"end":93},"obj":"UMLS/C0332306"},{"id":"T2065","span":{"begin":237,"end":244},"obj":"UMLS/C0332306"},{"id":"T2066","span":{"begin":413,"end":420},"obj":"UMLS/C0332306"},{"id":"T2067","span":{"begin":450,"end":457},"obj":"UMLS/C0332306"},{"id":"T2068","span":{"begin":603,"end":610},"obj":"UMLS/C0332306"},{"id":"T2069","span":{"begin":653,"end":660},"obj":"UMLS/C0332306"},{"id":"T2070","span":{"begin":694,"end":701},"obj":"UMLS/C0332306"},{"id":"T2071","span":{"begin":1362,"end":1369},"obj":"UMLS/C0332306"},{"id":"T2072","span":{"begin":355,"end":360},"obj":"UMLS/C0243095"},{"id":"T2073","span":{"begin":169,"end":173},"obj":"UMLS/C2700379"},{"id":"T2074","span":{"begin":444,"end":449},"obj":"UMLS/C0234886"},{"id":"T2075","span":{"begin":687,"end":693},"obj":"UMLS/C0234886"},{"id":"T2076","span":{"begin":29,"end":37},"obj":"UMLS/C1274040"},{"id":"T2077","span":{"begin":126,"end":134},"obj":"UMLS/C1274040"},{"id":"T2078","span":{"begin":290,"end":298},"obj":"UMLS/C1274040"},{"id":"T2079","span":{"begin":495,"end":503},"obj":"UMLS/C1274040"},{"id":"T2080","span":{"begin":520,"end":528},"obj":"UMLS/C1274040"},{"id":"T2081","span":{"begin":731,"end":738},"obj":"UMLS/C1274040"},{"id":"T2082","span":{"begin":981,"end":989},"obj":"UMLS/C1274040"},{"id":"T2083","span":{"begin":1231,"end":1239},"obj":"UMLS/C1274040"},{"id":"T2084","span":{"begin":731,"end":738},"obj":"UMLS/C0332294"},{"id":"T2085","span":{"begin":444,"end":449},"obj":"UMLS/C0205251"},{"id":"T2086","span":{"begin":687,"end":693},"obj":"UMLS/C0205251"},{"id":"T2087","span":{"begin":444,"end":449},"obj":"UMLS/C1611820"},{"id":"T2088","span":{"begin":687,"end":693},"obj":"UMLS/C1611820"},{"id":"T2089","span":{"begin":646,"end":652},"obj":"UMLS/C0205250"},{"id":"T2090","span":{"begin":1256,"end":1267},"obj":"UMLS/C1441506"},{"id":"T2091","span":{"begin":117,"end":125},"obj":"UMLS/C1552746"},{"id":"T2092","span":{"begin":486,"end":494},"obj":"UMLS/C1552746"},{"id":"T2093","span":{"begin":1240,"end":1248},"obj":"UMLS/C2700399"},{"id":"T2094","span":{"begin":971,"end":977},"obj":"UMLS/C0237753"},{"id":"T2095","span":{"begin":536,"end":542},"obj":"UMLS/C1280500"},{"id":"T2096","span":{"begin":169,"end":173},"obj":"UMLS/C0032854"},{"id":"T2097","span":{"begin":1335,"end":1340},"obj":"UMLS/C1546485"},{"id":"T2098","span":{"begin":117,"end":125},"obj":"UMLS/C1511545"},{"id":"T2099","span":{"begin":486,"end":494},"obj":"UMLS/C1511545"},{"id":"T2100","span":{"begin":731,"end":738},"obj":"UMLS/C1280519"},{"id":"T2101","span":{"begin":633,"end":638},"obj":"UMLS/C1704464"},{"id":"T2102","span":{"begin":990,"end":993},"obj":"UMLS/C0330664"},{"id":"T2103","span":{"begin":1127,"end":1132},"obj":"UMLS/C1550463"},{"id":"T2104","span":{"begin":916,"end":926},"obj":"UMLS/C0038215"},{"id":"T2105","span":{"begin":1240,"end":1248},"obj":"UMLS/C0332257"},{"id":"T2106","span":{"begin":1190,"end":1194},"obj":"UMLS/C0042789"},{"id":"T2107","span":{"begin":731,"end":738},"obj":"UMLS/C1546471"},{"id":"T2108","span":{"begin":169,"end":173},"obj":"UMLS/C0542537"},{"id":"T2109","span":{"begin":444,"end":449},"obj":"UMLS/C1550472"},{"id":"T2110","span":{"begin":687,"end":693},"obj":"UMLS/C1550472"},{"id":"T2111","span":{"begin":279,"end":289},"obj":"UMLS/C1550471"},{"id":"T2112","span":{"begin":536,"end":542},"obj":"UMLS/C2348382"},{"id":"T2113","span":{"begin":144,"end":152},"obj":"UMLS/C1522634"},{"id":"T2114","span":{"begin":329,"end":337},"obj":"UMLS/C1522634"},{"id":"T2115","span":{"begin":936,"end":944},"obj":"UMLS/C1522634"},{"id":"T2116","span":{"begin":50,"end":54},"obj":"UMLS/C0332268"},{"id":"T2117","span":{"begin":1127,"end":1132},"obj":"UMLS/C1457868"},{"id":"T2118","span":{"begin":646,"end":652},"obj":"UMLS/C1299351"},{"id":"T2119","span":{"begin":444,"end":449},"obj":"UMLS/C1299352"},{"id":"T2120","span":{"begin":687,"end":693},"obj":"UMLS/C1299352"},{"id":"T2121","span":{"begin":1183,"end":1189},"obj":"UMLS/C1522609"},{"id":"T2122","span":{"begin":555,"end":564},"obj":"UMLS/C0449738"},{"id":"T2123","span":{"begin":164,"end":168},"obj":"UMLS/C0323983"},{"id":"T3274","span":{"begin":782,"end":789},"obj":"UMLS/C1274040"},{"id":"T3275","span":{"begin":782,"end":789},"obj":"UMLS/C0332294"},{"id":"T3276","span":{"begin":782,"end":789},"obj":"UMLS/C1546471"},{"id":"T3277","span":{"begin":858,"end":865},"obj":"UMLS/C0332306"},{"id":"T3278","span":{"begin":791,"end":798},"obj":"UMLS/C1706244"},{"id":"T3279","span":{"begin":876,"end":884},"obj":"UMLS/C1707959"},{"id":"T3280","span":{"begin":791,"end":798},"obj":"UMLS/C1552616"},{"id":"T3281","span":{"begin":782,"end":789},"obj":"UMLS/C1280519"},{"id":"T3282","span":{"begin":892,"end":903},"obj":"UMLS/C0031928"},{"id":"T3283","span":{"begin":806,"end":816},"obj":"UMLS/C0022423"},{"id":"T3284","span":{"begin":832,"end":842},"obj":"UMLS/C2698624"},{"id":"T3285","span":{"begin":832,"end":842},"obj":"UMLS/C1707957"},{"id":"T3286","span":{"begin":791,"end":798},"obj":"UMLS/C2360088"},{"id":"T3287","span":{"begin":1428,"end":1437},"obj":"UMLS/C0680240"},{"id":"T3288","span":{"begin":1413,"end":1420},"obj":"UMLS/C1274040"},{"id":"T3289","span":{"begin":1413,"end":1420},"obj":"UMLS/C0332294"},{"id":"T3290","span":{"begin":1413,"end":1420},"obj":"UMLS/C1546471"},{"id":"T3291","span":{"begin":1478,"end":1486},"obj":"UMLS/C1707959"},{"id":"T3292","span":{"begin":1413,"end":1420},"obj":"UMLS/C1280519"},{"id":"T3293","span":{"begin":1494,"end":1505},"obj":"UMLS/C0031928"},{"id":"T3294","span":{"begin":1422,"end":1427},"obj":"UMLS/C0439099"},{"id":"T3295","span":{"begin":1448,"end":1458},"obj":"UMLS/C2698624"},{"id":"T3296","span":{"begin":1448,"end":1458},"obj":"UMLS/C1707957"}],"text":"Overall quality of important outcomes\nThere was a lack of agreement about the overall quality of evidence across the critical outcomes for each question (Table 5). This poor agreement reflected an accumulation of disagreements about the quality of evidence and importance of the individual outcomes that were considered for each question. In addition, we found that it did not make sense to downgrade the overall quality of evidence because of lower quality evidence for one of several critical outcomes when all of the outcomes showed effect in the same direction. We therefore agreed that the overall quality of evidence should be based on the higher quality evidence, rather than the lowest quality of evidence, when all of the results are in favour of the same option.\nTable 5 Results, summary of the judgements made by the 17 evaluators of the overall quality in the 12 examples in the pilot study The kappa statistics for each question are shown in Table 6. The number of outcomes per example range from two to seven and the kappa ranged from 0 to 0.82. In some instances, the agreement among the graders was slightly worse than by chance as indicated by the negative kappa values seen in Table 6. The kappa across the 46 outcomes included in the calculation was 0.395 (SE 0.008). Kappa for agreement beyond chance for the 12 final judgements about the quality of evidence was 0.270 (SE 0.015).\nTable 6 Results, kappa agreement among the evaluators for each of the 12 examples in the pilot study\n\nB"}