Evidence map›Paper›PMID 29386207›Full record

ArticleJournal of the American Heart Association2018

Absence of July Phenomenon in Acute Ischemic Stroke Care Quality and Outcomes.

Marco Gonzalez-Castellon, Christine Ju, Ying Xian, Adrian Hernandez, Gregg C Fonarow, Lee Schwamm, Eric E Smith, Deepak L Bhatt, Matthew Reeves, Joshua Z Willey

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Heart Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. 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

10 authors.

Marco Gonzalez-CastellonDepartment of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE.
Christine JuDuke Clinical Research Institute, Durham, NC.
Ying XianDepartment of Medicine, Duke University School of Medicine, Durham, NC.
Adrian HernandezDepartment of Medicine, Duke University School of Medicine, Durham, NC.
Gregg C FonarowRonald Reagan-UCLA Medical Center, Los Angeles, CA.
Lee SchwammDepartment of Neurology, Massachusetts General Hospital, Boston, MA.
Eric E SmithHotchkiss Brain Institute, University of Calgary, Alberta, Canada.
Deepak L BhattBrigham and Women's Heart & Vascular Center and Harvard Medical School, Boston, MA.
Matthew ReevesDepartment of Epidemiology, Michigan State University, East Lansing, MI.
Joshua Z WilleyDivision of Stroke, Department of Neurology, Columbia University Medical Center, New York, NY jzw2@cumc.columbia.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLower care quality and an increase in adverse outcomes as a result of new medical trainees is a concept well rooted in popular belief, termed the "July phenomenon." Whether this phenomenon occurs in acute ischemic stroke has not been well studied. METHODS AND

resultsWe analyzed data from patients admitted with ischemic stroke in 1625 hospitals participating in the Get With The Guidelines-Stroke program for the 5-year period between January 2009 and December 2013. We compared acute stroke treatment processes and in-hospitals outcomes among the 4 quarters (first quarter: July-September, last quarter: April-June) of the academic year. Multivariable logistic regression models were used to evaluate the relationship between academic year transition and processes measures. A total of 967 891 patients were included in the study. There was a statistically significant, but modest (<4 minutes or 5 percentage points) difference in distribution of or quality and clinical metrics including door-to-computerized tomography time, door-to-needle time, the proportion of patients with symptomatic intracranial hemorrhage within 36 hours of admission, and the proportion of patients who received defect-free care in stroke performance measures among academic year quarters (

conclusionsWe found no evidence of the "July phenomenon" in patients with acute ischemic stroke among hospitals participating in the Get With The Guidelines-Stroke program.

Indexed as

AgedAged, 80 and overBrain IschemiaClinical CompetenceFemaleHealth StatusHospitals, TeachingHumansInternship and ResidencyMaleMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionPatient DischargePersonnel Staffing and SchedulingQuality Indicators, Health Careischemic strokethrombolysis

Identifiers

PMID29386207
PMCPMC5850252

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.