Trial reportBMJ quality & safety2019
Effects and costs of implementing predictive risk stratification in primary care: a randomised stepped wedge trial.
Trial report in BMJ quality & safety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled 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.
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
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Health Economic Evaluation Alongside Stepped Wedge Trials: A Methodological Systematic Review.PharmacoEconomics · 2021Pooled it
- Impact of an integrated community-based model of care for older people with complex conditions on hospital emergency presentations and admissions: a step-wedged cluster randomized trial.BMC health services research · 2021Trial
- Article
- Improving event prediction using general practitioner clinical judgement in a digital risk stratification model: a pilot study.BMC medical informatics and decision making · 2024Article
- Evaluation of the shielding initiative in Wales (EVITE Immunity): protocol for a quasiexperimental study.BMJ open · 2022Article
- Article
- A systematic review of risk stratification tools internationally used in primary care settings.Health science reports · 2021Review
- Evaluation of an intervention targeted with predictive analytics to prevent readmissions in an integrated health system: observational study.BMJ (Clinical research ed.) · 2021Observational
- Cutting edge or blunt instrument: how to decide if a stepped wedge design is right for you.BMJ quality & safety · 2021Review
- Multimorbidity combinations, costs of hospital care and potentially preventable emergency admissions in England: A cohort study.PLoS medicine · 2021Article
- (Dis)Integrated Care? Lessons from East London.International journal of integrated care · 2020Article
- Assessing the Impact of A Community-Based Pro-Active Monitoring Program Addressing the need for Care of Community-Dwelling Citizens aged more than 80: Protocol for a Prospective Pragmatic Trial and Results of the Baseline Assessment.Translational medicine @ UniSa · 2020Article
- Emergency admission risk stratification tools in UK primary care: a cross-sectional survey of availability and use.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Machine learning and artificial intelligence research for patient benefit: 20 critical questions on transparency, replicability, ethics, and effectiveness.BMJ (Clinical research ed.) · 2020Article
- A co-produced method to involve service users in research: the SUCCESS model.BMC medical research methodology · 2019Article
Corrections and comments
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Authors and funding
22 authors.
Funding
Abstract
aimWe evaluated the introduction of a predictive risk stratification model (PRISM) into primary care. Contemporaneously National Health Service (NHS) Wales introduced Quality and Outcomes Framework payments to general practices to focus care on those at highest risk of emergency admission to hospital. The aim of this study was to evaluate the costs and effects of introducing PRISM into primary care.
methodsRandomised stepped wedge trial with 32 general practices in one Welsh health board. The intervention comprised: PRISM software; practice-based training; clinical support through two 'general practitioner (GP) champions' and technical support. The primary outcome was emergency hospital admissions.
resultsAcross 230 099 participants, PRISM implementation increased use of health services: emergency hospital admission rates by 1 % when untransformed (while change in log-transformed rate Δ
conclusionsIntroduction of PRISM resulted in a statistically significant increase in emergency hospital admissions and use of other NHS services without evidence of benefits to patients or the NHS.
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Registered trials
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.