Evidence map›Paper›PMID 27008685›Full record

SynthesisBMJ open2016

Impact analysis studies of clinical prediction rules relevant to primary care: a systematic review.

Emma Wallace, Maike J M Uijen, Barbara Clyne, Atieh Zarabzadeh, Claire Keogh, Rose Galvin, Susan M Smith, Tom Fahey

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
10.9field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

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

23 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.

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  18. The number needed to benefit: estimating the value of predictive analytics in healthcare.Journal of the American Medical Informatics Association : JAMIA · 2019
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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

8 authors at 2 institutions in 2 countries.

Emma WallaceHRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
Maike J M UijenHRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin 2, Ireland Medical school, Radboud University, Nijmegen, The Netherlands.
Barbara ClyneHRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
Atieh ZarabzadehHRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
Claire KeoghHRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
Rose GalvinHRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin 2, Ireland Department of Clinical Therapies, University of Limerick, Limerick, Ireland.
Susan M SmithHRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
Tom FaheyHRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
Royal College of Surgeons in Ireland · IEUniversity of Limerick · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesFollowing appropriate validation, clinical prediction rules (CPRs) should undergo impact analysis to evaluate their effect on patient care. The aim of this systematic review is to narratively review and critically appraise CPR impact analysis studies relevant to primary care.

settingPrimary care.

participantsAdults and children.

interventionStudies that implemented the CPR compared to usual care were included. STUDY

designRandomised controlled trial (RCT), controlled before-after, and interrupted time series. PRIMARY OUTCOME: Physician behaviour and/or patient outcomes.

resultsA total of 18 studies, incorporating 14 unique CPRs, were included. The main study design was RCT (n=13). Overall, 10 studies reported an improvement in primary outcome with CPR implementation. Of 6 musculoskeletal studies, 5 were effective in altering targeted physician behaviour in ordering imaging for patients presenting with ankle, knee and neck musculoskeletal injuries. Of 6 cardiovascular studies, 4 implemented cardiovascular risk scores, and 3 reported no impact on physician behaviour outcomes, such as prescribing and referral, or patient outcomes, such as reduction in serum lipid levels. 2 studies examined CPRs in decision-making for patients presenting with chest pain and reduced inappropriate admissions. Of 5 respiratory studies, 2 were effective in reducing antibiotic prescribing for sore throat following CPR implementation. Overall, study methodological quality was often unclear due to incomplete reporting.

conclusionsDespite increasing interest in developing and validating CPRs relevant to primary care, relatively few have gone through impact analysis. To date, research has focused on a small number of CPRs across few clinical domains only.

Indexed as

Decision MakingDecision Support TechniquesHumansInterrupted Time Series AnalysisPrimary Health CareRandomized Controlled Trials as TopicRisk Factorsclinical prediction ruleimpact analysisrisk prediction

Identifiers

PMID27008685
PMCPMC4800123
OpenAlexW2303461585

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.