Evidence map›Paper›PMID 32004709›Full record

Trial reportAcademic pediatrics2020

Clinical Decision Support for Recognizing and Managing Hypertensive Blood Pressure in Youth: No Significant Impact on Medical Costs.

Steven P Dehmer, Alan R Sinaiko, Nicole K Trower, Stephen E Asche, Heidi L Ekstrom, James D Nordin, Patrick J O'Connor, Elyse O Kharbanda

Open access · greenAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Academic pediatrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 41% 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

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. 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 at 2 institutions in 1 country.

Steven P DehmerHealthPartners Institute (SP Dehmer, NK Trower, SE Asche, HL Ekstrom, JD Nordin, PJ O'Connor, and EO Kharbanda), Minneapolis, Minn. Electronic address: steven.p.dehmer@healthpartners.com.
Alan R SinaikoDepartment of Pediatrics, University of Minnesota (AR Sinaiko), Minneapolis, Minn.
Nicole K TrowerHealthPartners Institute (SP Dehmer, NK Trower, SE Asche, HL Ekstrom, JD Nordin, PJ O'Connor, and EO Kharbanda), Minneapolis, Minn.
Stephen E AscheHealthPartners Institute (SP Dehmer, NK Trower, SE Asche, HL Ekstrom, JD Nordin, PJ O'Connor, and EO Kharbanda), Minneapolis, Minn.
Heidi L EkstromHealthPartners Institute (SP Dehmer, NK Trower, SE Asche, HL Ekstrom, JD Nordin, PJ O'Connor, and EO Kharbanda), Minneapolis, Minn.
James D NordinHealthPartners Institute (SP Dehmer, NK Trower, SE Asche, HL Ekstrom, JD Nordin, PJ O'Connor, and EO Kharbanda), Minneapolis, Minn.
Patrick J O'ConnorHealthPartners Institute (SP Dehmer, NK Trower, SE Asche, HL Ekstrom, JD Nordin, PJ O'Connor, and EO Kharbanda), Minneapolis, Minn.
Elyse O KharbandaHealthPartners Institute (SP Dehmer, NK Trower, SE Asche, HL Ekstrom, JD Nordin, PJ O'Connor, and EO Kharbanda), Minneapolis, Minn.
HealthPartners · USUniversity of Minnesota · US

Funding

Translational Research Core - Health Engagement & Action Translational (HEAT)P30DK092924 · NIDDK · KAISER FOUNDATION RESEARCH INSTITUTE · PI Alyce Sophia Adams, HILARY Kessler SELIGMAN · 2011 to 2026
$9.2M
EHR-Based Clinical Decision Support to Improve BP Management in AdolescentsR01HL115082 · NHLBI · HEALTHPARTNERS INSTITUTE · PI KHARBANDA, ELYSE OLSHEN · 2012 to 2016
$2.9M
NHLBI NIH HHS R01 HL115082NIDDK NIH HHS P30 DK092924
6 · The paper itself

Abstract

objectiveTo evaluate economic costs from the health system perspective of an electronic health record-based clinical decision support (CDS) tool, TeenBP, designed to assist in the recognition and management of hypertension in youth.

methodsTwenty primary care clinics within an integrated health system were randomized to the TeenBP CDS or usual care (UC), with patient enrollment from 4/15/14 to 4/14/16. The 12-month change in standardized medical care costs for insured patients aged 10 to 17 years without prior hypertension were calculated for each study arm. The primary analysis compared patients with ≥1 visit with blood pressure (BP) ≥95th percentile (isolated hypertensive BP), and secondary analyses compared patients with ≥3 visits within one year with BP ≥95th percentile (incident hypertension). Generalized estimating equation models estimated the difference-in-differences in costs between groups over time.

resultsAmong 925 insured patients with an isolated hypertensive BP, the pre-to-post change in overall costs averaged $22 more for TeenBP CDS versus UC patients over 12 months, but this difference was not statistically significant (P = .723). Among 159 insured patients with incident hypertension, the pre-to-post change in overall costs over 12 months was higher by $227 per person on average for TeenBP CDS versus UC patients, but this difference also was not statistically significant (P = .313).

conclusionsThe TeenBP CDS intervention was previously found to significantly improve identification and management of hypertensive BP in youth, and in this study, we find that this tool did not significantly increase care costs in its first 12 months of clinical use.

Indexed as

AdolescentChildCosts and Cost AnalysisDecision Support Systems, ClinicalDelivery of Health Care, IntegratedElectronic Health RecordsFemaleHealth Care CostsHumansHypertensionMalePrimary Health Carecostsdecision supporteconomic analysishypertension

Identifiers

PMID32004709
PMCPMC7872738
OpenAlexW3003185961

What OpenQuestion holds

Textmetadata
LicenceTDM
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.