Evidence map›Paper›PMID 21435250›Full record

ArticleBMC health services research2011

Emergency department documentation templates: variability in template selection and association with physical examination and test ordering in dizziness presentations.

Kevin A Kerber, Timothy P Hofer, William J Meurer, A Mark Fendrick, Lewis B Morgenstern

Abstract read
In one paragraph

Article in BMC health services research, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Clinical documentation: composition or synthesis?Journal of the American Medical Informatics Association : JAMIA
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kevin A KerberDepartment of Neurology, University of Michigan Health System, Ann Arbor, MI, USA. kakerber@umich.edu
Timothy P Hofer
William J Meurer
A Mark Fendrick
Lewis B Morgenstern

Funding

Dizziness in the Emergency Department: A Population-Based ProjectK23RR024009 · NCRR · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI KERBER, KEVIN ANTHONY · 2007 to 2011
$797k
NCRR NIH HHS K23 RR024009
6 · The paper itself

Abstract

backgroundClinical documentation systems, such as templates, have been associated with process utilization. The T-System emergency department (ED) templates are widely used but lacking are analyses of the templates association with processes. This system is also unique because of the many different template options available, and thus the selection of the template may also be important. We aimed to describe the selection of templates in ED dizziness presentations and to investigate the association between items on templates and process utilization.

methodsDizziness visits were captured from a population-based study of EDs that use documentation templates. Two relevant process outcomes were assessed: head computerized tomography (CT) scan and nystagmus examination. Multivariable logistic regression was used to estimate the probability of each outcome for patients who did or did not receive a relevant-item template. Propensity scores were also used to adjust for selection effects.

resultsThe final cohort was 1,485 visits. Thirty-one different templates were used. Use of a template with a head CT item was associated with an increase in the adjusted probability of head CT utilization from 12.2% (95% CI, 8.9%-16.6%) to 29.3% (95% CI, 26.0%-32.9%). The adjusted probability of documentation of a nystagmus assessment increased from 12.0% (95%CI, 8.8%-16.2%) when a nystagmus-item template was not used to 95.0% (95% CI, 92.8%-96.6%) when a nystagmus-item template was used. The associations remained significant after propensity score adjustments.

conclusionsProviders use many different templates in dizziness presentations. Important differences exist in the various templates and the template that is used likely impacts process utilization, even though selection may be arbitrary. The optimal design and selection of templates may offer a feasible and effective opportunity to improve care delivery.

Indexed as

Emergency Service, HospitalAdultAgedClinical CodingDizzinessFemaleHeadHumansLogistic ModelsMaleMedical AuditMedical RecordsMiddle AgedNystagmus, PhysiologicOutcome Assessment, Health CarePhysical Examination

Identifiers

PMID21435250
PMCPMC3073892

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.