Evidence map›Paper›PMID 33656914›Full record

ArticleJCO clinical cancer informatics2021

Aligning EHR Data for Pediatric Leukemia With Standard Protocol Therapy.

Nicole M Wood, Sierra Davis, Karen Lewing, Janelle Noel-MacDonnell, Earl F Glynn, Doina Caragea, Mark A Hoffman

Open access · hybridAbstract read
In one paragraph

Article in JCO clinical cancer informatics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 37% 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, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  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

7 authors at 3 institutions in 1 country.

Nicole M WoodDepartment of Pediatrics, Children's Mercy Hospital, Kansas City, MO.ORCID 0000-0002-7906-5151
Sierra DavisChildren's Mercy Research Institute, Kansas City, MO.
Karen LewingDepartment of Pediatrics, Children's Mercy Hospital, Kansas City, MO.ORCID 0000-0003-1062-3861
Janelle Noel-MacDonnellDepartment of Pediatrics, Children's Mercy Hospital, Kansas City, MO.ORCID 0000-0002-8171-6056
Earl F GlynnChildren's Mercy Research Institute, Kansas City, MO.ORCID 0000-0002-2674-453X
Doina CarageaKansas State University, Manhattan, KS.ORCID 0000-0002-6440-0914
Mark A HoffmanDepartment of Pediatrics, Children's Mercy Hospital, Kansas City, MO.ORCID 0000-0003-3140-6524
Children's Mercy Hospital · USMercy Research · USKansas State University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeChildren with acute lymphoblastic leukemia (ALL) are treated according to risk-based protocols defined by the Children's Oncology Group (COG). Alignment between real-world clinical practice and protocol milestones is not widely understood. Aggregate deidentified electronic health record (EHR) data offer a useful resource to evaluate real-world clinical practice.

methodsA cohort of children with ALL was identified in the Cerner Health Facts deidentified aggregate EHR data. Manual review identified candidate procedural milestones. Automated methods were developed to classify likely standard-risk precursor B-cell ALL patients. Milestone procedures were adjusted relative to initiation of therapy and then aligned to the COG protocols for standard induction therapy.

resultsWe identified 7,728 patients with pediatric ALL with 188,187 encounters. Records for lumbar punctures (LP) and bone marrow biopsies were frequently present in the data and were appropriate targets to evaluate guideline performance. Alluvial graph analysis of 14 health systems indicated that none of the systems have data from all three COG-recommended lumbar procedures for all patients but alignment demonstrated that most systems test at the recommended times.

conclusionSource-system variation introduces inconsistency and incompleteness into aggregate EHR data. Data visualization was helpful in characterizing and interpreting the data. Health systems with patients meeting the inclusion criteria demonstrated strong alignment with the recommended milestones for LP. Large-scale aggregate EHR data are useful to evaluate alignment of recommended versus actual clinical milestones in support of treating children with ALL. This work can inform other guideline and protocol driven care.

Indexed as

Electronic Health RecordsLeukemiaChildCohort StudiesHumansStandard of Care

Identifiers

PMID33656914
PMCPMC8140784
OpenAlexW3134471614

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.