Evidence map›Paper›PMID 29785895›Full record

ArticlePrimary health care research & development2018

Complexity in pediatric primary care.

Arwa Nasir, Laeth Nasir, Ariel Tarrell, David Finken, Amy Lacroix, Swetha Pinninti, Sheryl Pitner, Molly McCarthy

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In one paragraph

Article in Primary health care research & development, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
  4. Article
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  6. 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

8 authors.

Arwa NasirDepartment of Pediatrics, 982167 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, USA.
Laeth NasirCreighton University School of Medicine, Omaha, NE, USA.
Ariel TarrellDepartment of Pediatrics, 982167 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, USA.
David FinkenDepartment of Pediatrics, 982167 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, USA.
Amy LacroixDepartment of Pediatrics, 982167 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, USA.
Swetha PinnintiDepartment of Pediatrics, 982167 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, USA.
Sheryl PitnerDepartment of Pediatrics, 982167 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, USA.
Molly McCarthyCollege of Public Health, 984365 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe management of patients in primary care is often complicated by the presence of multiple chronic conditions and psychosocial issues that increase the complexity of the encounter and have important impacts on care. There is a paucity of literature on this subject in the pediatric population.

objectivesThe aim of this study was to quantify the burden of chronic conditions in pediatric primary care.

methodsThe problem lists of 3995 randomly selected patients from a community pediatric clinic and an academic hospital-based pediatric clinic in the same metropolitan area were analyzed for the presence and number of any chronic condition.

resultsIn total, 53% of patients suffered from at least one chronic problem, 25% had two or more chronic conditions and 5.1% had four or more conditions. Compared with the community clinic, the academic clinic had significantly more children with catastrophic complex conditions (P<0.001). A regression analysis showed a significant positive correlation between the number of chronic medical conditions and mental health diagnoses.

conclusionsThe burden of chronic disease in the pediatric primary care setting may be significantly higher than has been previously suggested. To ensure optimal quality of care, health planners should take into account the high burden of chronic illness, psychosocial issues and multimorbidity among patients in the pediatric primary care setting, as well as the higher complexity profile of patients attending academic clinics.

Indexed as

chronic medical complexitymultimorbiditypediatric primary carepsychosocial morbidity

Identifiers

PMID29785895
PMCPMC8512535

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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.