Evidence map›Paper›PMID 31594901›Full record

ArticleBMJ open2019

Examining consensus for a standardised patient assessment in community paramedicine home visits: a RAND/UCLA-modified Delphi Study.

Matthew S Leyenaar, Ryan P Strum, Alan M Batt, Samir Sinha, Michael Nolan, Gina Agarwal, Walter Tavares, Andrew P Costa

Abstract readConsensus Statement
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Article
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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.

Matthew S LeyenaarHealth Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada leyenam@mcmaster.ca.ORCID 0000-0002-1151-9479
Ryan P StrumHealth Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Alan M BattSchool of Public Safety, Fanshawe College, London, Ontario, Canada.
Samir SinhaThe Ontario Community Paramedicine Secretariat, Toronto, Ontario, Canada.
Michael NolanThe Ontario Community Paramedicine Secretariat, Toronto, Ontario, Canada.
Gina AgarwalHealth Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-5691-4675
Walter TavaresThe Wilson Centre and Post MD Education, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.
Andrew P CostaHealth Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Funding

CIHR
6 · The paper itself

Abstract

objectiveCommunity paramedicine programme are often designed to address repeated and non-urgent use of paramedic services by providing patients with alternatives to the traditional 'treat and transport' ambulance model of care. We sought to investigate the level of consensus that could be found by a panel of experts regarding appropriate health, social and environmental domains that should be assessed in community paramedicine home visit programme.

designWe applied the RAND/UCLA Appropriateness Method in a modified Delphi method to investigate the level of consensus on assessment domains for use in community paramedicine home visit programme. SETTING AND

participantsWe included a multi-national panel of 17 experts on community paramedicine and in-home assessment from multiple settings (paramedicine, primary care, mental health, home and community care, geriatric care). MEASURES: A list of potential assessment categories was established after a targeted literature review and confirmed by panel members. Over multiple rounds, panel members scored the appropriateness of 48 assessment domains on a Likert scale from 0 (not appropriate) to 5 (very appropriate). Scores were then reviewed at an in-person meeting and a finalised list of assessment domains was generated.

resultsAfter the preliminary round of scoring, all 48 assessment domains had scores that demonstrated consensus. Nine assessment domains (18.8%) demonstrated a wider range of rated appropriateness. No domains were found to be not appropriate. Achieving consensus about the appropriateness of assessment domains on the first round of scoring negated the need for subsequent rounds of scoring. The in-person meeting resulted in re-grouping assessment domains and adding an additional domain about urinary continence.

conclusionAn international panel of experts with knowledge about in-home assessment by community paramedics demonstrated a high level of agreement on appropriate patient assessment domains for community paramedicine home visit programme. Community paramedicine home visit programme are likely to have similar patient populations. A standardised assessment instrument may be viable in multiple settings.

Indexed as

Allied Health PersonnelCommunity Health ServicesEmergency Medical ServicesHome Care ServicesPatient CareSymptom AssessmentCanadaDelphi TechniqueHumansQuality Indicators, Health CareResearch Designaccident & emergency medicineassessmentcommunity paramedicineemergency medical serviceshealth services administration & managementquality in health care

Identifiers

PMID31594901
PMCPMC6797257

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Registered trials

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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.