Evidence map›Paper›PMID 33305221›Full record

ArticleCJC open2020

Despite Having Worse Risk Profiles, Northern Albertans Wait Longer for Specialist Follow-up After Emergency Department Visits for Atrial Fibrillation.

Brian H Rowe, Finlay A McAlister, Michelle M Graham, Brian R Holroyd, Rhonda J Rosychuk

Abstract read
In one paragraph

Article in CJC open, 2020. 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
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0citing papers in PubMed
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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.

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

5 authors.

Brian H RoweDepartment of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada.
Finlay A McAlisterAlberta Health Services, Edmonton, Alberta, Canada.
Michelle M GrahamDepartment of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Brian R HolroydDepartment of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada.
Rhonda J RosychukDepartment of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtrial fibrillation and flutter (AFF) are common arrhythmias diagnosed in the emergency department (ED), and prompt follow-up with specialists may yield better outcomes. This study examines time to first specialist outpatient visit following ED discharge for AFF.

methodsAlberta residents aged ≥ 35 years with ED presentations for AFF ending in discharge during 2017-2018 were extracted and linked with hospitalizations and physician claims. A spatial scan and multinomial logistic regression were performed. Regression model predictors included demographics, prior diagnoses, and prior health service use.

resultsED presentations for 4387 patients (54% male; mean age 68 years) were analyzed. Two geographic areas were identified as clusters that had longer times than would be expected by chance: a north cluster of northern areas with an estimated median time of 98 days (95% confidence interval [CI] 82,139), and an east cluster of eastern areas with a median of 57 days (95% CI 47, 68). Patients in the north cluster were more likely to be younger (adjusted odds ratio [aOR] = 0.76 per 5 years, 95% CI 0.62, 0.93) and have prior histories of AFF (aOR = 1.45, 95% CI 1.11, 1.90), congestive heart failure (aOR=1.51, 95% CI 1.15, 1.98), chronic obstructive pulmonary disease (aOR = 2.03, 95% CI 1.55, 2.65), and diabetes (aOR = 1.30, 95% CI 1.00, 1.67). They were less likely to have prior general practitioner outpatient visits (aOR = 0.65 per 5 visits, 95% CI 0.53, 0.81) and specialist outpatient visits (aOR = 0.39, 95% CI 0.30, 0.50) than other patients.

conclusionsDespite being at higher risk, patients in northern areas took longer to see a specialist after an ED presentation for AFF than those from other regions. Innovative strategies for promoting specialist follow-up should be explored.

Identifiers

PMID33305221
PMCPMC7710999

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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.