SynthesisJournal of general internal medicine2016
A Systematic Review of Conceptual Frameworks of Medical Complexity and New Model Development.
Synthesis in Journal of general internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
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.
Who cites it
53 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Hospital-to-home transitions for children with medical complexity: part 1, a systematic review of reported outcomes.European journal of pediatrics · 2023Pooled it
- Pooled it
- Call to Make Equity Actionable in Frontline Practice in Learning Health Systems Using Implementation Science.Journal of general internal medicine · 2026Article
- Article
- Understanding the treatment journey and experiences of knee osteoarthritis patients receiving standard care in Singapore: a qualitative study.BMC health services research · 2026Article
- Perceived Connections Between Personal Values and Health in High-Risk Patients with Multimorbidity: A Qualitative Study.Journal of general internal medicine · 2026Article
- Patient safety incidents in mental health residential services: a multicenter, crosssectional, survey-based study.Frontiers in psychiatry · 2026Article
- Article
- Quality-of-life factors at home and in health care settings for people living with dementia.The Gerontologist · 2025Article
- Pre-post changes of integrated care needs in patients undergoing bariatric surgery.International journal of obesity (2005) · 2025Article
- Validation of a questionnaire to assess complexity of palliative care needs in primary care in Malaga, Spain: a study protocol.BMJ open · 2025Article
- Dynamic few-shot prompting for clinical note section classification using lightweight, open-source large language models.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Understanding the complexity of decision-making for mothers of young children with ambulatory cerebral palsy: A qualitative phenomenological study.Developmental medicine and child neurology · 2025Article
- Implementing evidence-based practices to improve primary care for high-risk patients: study protocol for the VA high-RIsk VETerans (RIVET) type III effectiveness-implementation trial.Implementation science communications · 2024Article
- Beyond Diagnosis and Comorbidities-A Scoping Review of the Best Tools to Measure Complexity for Populations with Mental Illness.Diagnostics (Basel, Switzerland) · 2024Article
- How family physicians in Singapore recognise complexity during consultations: a qualitative study.BMC primary care · 2024Article
- Complexity of patients with or without infectious disease consultation in tertiary-care hospitals in Germany.Infection · 2024Article
- Association between patient-reported social and behavioral risks and health care costs in high-risk Veterans health administration patients.Health services research · 2024Article
- Managing Complexity: Black Older Adults With Multimorbidity.The Gerontologist · 2024Article
- Caring for high-need patients.BMC health services research · 2023Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundPatient complexity is often operationalized by counting multiple chronic conditions (MCC) without considering contextual factors that can affect patient risk for adverse outcomes.
objectiveOur objective was to develop a conceptual model of complexity addressing gaps identified in a review of published conceptual models. DATA SOURCES: We searched for English-language MEDLINE papers published between 1 January 2004 and 16 January 2014. Two reviewers independently evaluated abstracts and all authors contributed to the development of the conceptual model in an iterative process.
resultsFrom 1606 identified abstracts, six conceptual models were selected. One additional model was identified through reference review. Each model had strengths, but several constructs were not fully considered: 1) contextual factors; 2) dynamics of complexity; 3) patients' preferences; 4) acute health shocks; and 5) resilience. Our Cycle of Complexity model illustrates relationships between acute shocks and medical events, healthcare access and utilization, workload and capacity, and patient preferences in the context of interpersonal, organizational, and community factors. CONCLUSIONS/IMPLICATIONS: This model may inform studies on the etiology of and changes in complexity, the relationship between complexity and patient outcomes, and intervention development to improve modifiable elements of complex patients.
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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.