Evidence map›Paper›PMID 31429747›Full record

ArticleBMC medical informatics and decision making2019

Thrombophilia testing in the inpatient setting: impact of an educational intervention.

Henry Kwang, Eric Mou, Ilana Richman, Andre Kumar, Caroline Berube, Rajani Kaimal, Neera Ahuja, Stephanie Harman, Tyler Johnson, Neil Shah and 4 more

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

Article in BMC medical informatics and decision making, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
1.5field-weighted citation impact, top 15% 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

0 citing papers in PubMed, 9 citations in OpenAlex.

No citing paper in PubMed yet.

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

14 authors at 4 institutions in 1 country.

Henry KwangDepartment of Medicine, Stanford University, Stanford, CA, USA.
Eric MouDivision of Hematology, Department of Medicine, Stanford University, Stanford, CA, USA.
Ilana RichmanDepartment of Medicine, Yale School of Medicine, New Haven, CT, USA.
Andre KumarDivision of Hospital Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, HC007, Stanford, CA, 94305, USA.
Caroline BerubeDivision of Hematology, Department of Medicine, Stanford University, Stanford, CA, USA.
Rajani KaimalDepartment of Medicine, Quantitative Sciences Unit, Stanford University, Stanford, CA, USA.
Neera AhujaDivision of Hospital Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, HC007, Stanford, CA, 94305, USA.
Stephanie HarmanDivision of Palliative Care, Department of Medicine, Stanford University, Stanford, CA, USA.
Tyler JohnsonDivision of Oncology, Department of Medicine, Stanford University, Stanford, CA, USA.
Neil ShahDepartment of Pathology, Stanford University, Stanford, CA, USA.
Ronald WittelesDivision of Cardiology, Department of Medicine, Stanford University, Stanford, CA, USA.
Robert HarringtonDivision of Cardiology, Department of Medicine, Stanford University, Stanford, CA, USA.
Lisa ShiehDivision of Hospital Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, HC007, Stanford, CA, 94305, USA. lshieh@stanford.edu.
Jason HomDivision of Hospital Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, HC007, Stanford, CA, 94305, USA. jasonhom@stanford.edu.ORCID 0000-0002-8404-5796
Stanford University · USStanford Health Care · USStanford Medicine · USYale University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

backgroundThrombophilia testing is frequently ordered in the inpatient setting despite its limited impact on clinical decision-making and unreliable results in the setting of acute thrombosis or ongoing anticoagulation. We sought to determine the effect of an educational intervention in reducing inappropriate thrombophilia testing for hospitalized patients.

methodsDuring the 2014 academic year, we implemented an educational intervention with a phase implementation design for Internal Medicine interns at Stanford University Hospital. The educational session covering epidemiology, appropriate thrombophilia evaluation and clinical rationale behind these recommendations. Their ordering behavior was compared with a contemporaneous control (non-medicine and private services) and a historical control (interns from prior academic year). From the analyzed data, we determined the proportion of inappropriate thrombophilia testing of each group. Logistic generalized estimating equations were used to estimate odds ratios for inappropriate thrombophilia testing associated with the intervention.

resultsOf 2151 orders included, 934 were deemed inappropriate (43.4%). The two intervention groups placed 147 orders. A pooled analysis of ordering practices by intervention groups revealed a trend toward reduction of inappropriate ordering (p = 0.053). By the end of the study, the intervention groups had significantly lower rates of inappropriate testing compared to historical or contemporaneous controls.

conclusionA brief educational intervention was associated with a trend toward reduction in inappropriate thrombophilia testing. These findings suggest that focused education on thrombophilia testing can positively impact inpatient ordering practices.

Indexed as

HospitalizationInternship and ResidencyAdultFemaleHospitals, UniversityHumansInternal MedicineMalePatient SelectionThrombophiliaEducationHigh value careInpatientThrombophilia

Identifiers

PMID31429747
PMCPMC6701078
OpenAlexW2969860292

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.