Evidence map›Paper›PMID 32360959›Full record

Trial reportJournal of the American College of Surgeons2020

Clinical Decision Support Intervention for Rib Fracture Treatment.

Chad Macheel, Patty Reicks, Cori Sybrant, Cory Evans, Joseph Farhat, Michaela A West, Christopher J Tignanelli

Open access · greenAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American College of Surgeons, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
3.5field-weighted citation impact, top 7% 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

10 citing papers in PubMed, 26 citations in OpenAlex.

  1. Article
  2. Observational
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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

7 authors at 4 institutions in 1 country.

Chad MacheelTrauma Services, North Memorial Health Hospital, Robbinsdale, University of Minnesota, Minneapolis, MN.
Patty ReicksTrauma Services, North Memorial Health Hospital, Robbinsdale, University of Minnesota, Minneapolis, MN.
Cori SybrantTrauma Services, North Memorial Health Hospital, Robbinsdale, University of Minnesota, Minneapolis, MN.
Cory EvansDepartment of Surgery, University of Tennessee Health Science Center, Memphis, TN.
Joseph FarhatTrauma Services, North Memorial Health Hospital, Robbinsdale, University of Minnesota, Minneapolis, MN.
Michaela A WestTrauma Services, North Memorial Health Hospital, Robbinsdale, University of Minnesota, Minneapolis, MN; Department of Surgery, University of Minnesota, Minneapolis, MN.
Christopher J TignanelliTrauma Services, North Memorial Health Hospital, Robbinsdale, University of Minnesota, Minneapolis, MN; Department of Surgery, University of Minnesota, Minneapolis, MN; Institute for Health Informatics, University of Minnesota, Minneapolis, MN. Electronic address: ctignane@umn.edu.
North Memorial Health Care · USUniversity of Minnesota · USAmerican College of Surgeons · USUniversity of Tennessee Health Science Center · US

Funding

Institutional Career Development CoreKL2TR002492 · NCATS · UNIVERSITY OF MINNESOTA · PI INGBAR, DAVID H · 2018 to 2022
$6.3M
Minnesota Learning Health System Mentored Career Development Program (MN-LHS)K12HS026379 · AHRQ · UNIVERSITY OF MINNESOTA · PI BEEBE, TIMOTHY, LINZER, MARK · 2018 to 2022
$2.9M
AHRQ HHS K12 HS026379NCATS NIH HHS KL2 TR002492
6 · The paper itself

Abstract

backgroundRib fractures are associated with significant morbidity and mortality. Despite the publication of management guidelines and national outcomes benchmarking, there is significant variation in evidence-based (EB) adherence and outcomes. Systems for clinical decision support intervention (CDSI) allow rapid ordering of bundled disease-specific EB treatments. We developed an EB rib fracture protocol and CDSI at our institution. The purpose of the current study was to evaluate implementation and clinical outcomes using this CDSI. STUDY

designA rib fracture care CDSI was developed, disseminated, and implemented in July 2018. Implementation outcomes were evaluated using the Proctor framework. Adherence was tracked monthly via run charts and acceptance was evaluated on a 7-point Likert scale using the Unified Theory of Acceptance and Use of Technology questionnaire. Propensity score matching was used to compare in-hospital morbidity and mortality in pre-implementation (January 1, 2016 through December 31, 2016) vs post-implementation (September 1, 2018 through April 30, 2019) cohorts.

resultsA total of 197 patients were eligible for the intervention. Provider CDSI adherence was 83% at 1 month and reached 100% after 7 months. Acceptance of CDSI using the Unified Theory of Acceptance and Use of Technology had a mean Likert score higher than 6 (range 6.1 to 6.8, SD 0.5 to 1.5), indicating high acceptance. A significant reduction in hospital length of stay was found post implementation (incident rate ratio 0.80; 95% CI, 0.66 to 0.98; p = 0.03) comparing propensity-matched subjects.

conclusionsThe development and use of a CDSI resulted in improved provider delivery of EB practice and was associated with reduced hospital length of stay.

Indexed as

Decision Support Systems, ClinicalAdultAgedAged, 80 and overClinical ProtocolsElectronic Health RecordsFemaleGuideline AdherenceHospital MortalityHumansLength of StayLogistic ModelsMaleMiddle AgedPractice Guidelines as TopicPractice Patterns, Physicians'

Identifiers

PMID32360959
PMCPMC8553577
OpenAlexW3021011715

What OpenQuestion holds

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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.