Evidence map›Paper›PMID 33851118›Full record

ArticleKidney medicine

Patient Electronic Health Record Portal Use and Patient-Centered Outcomes in CKD.

June Tome, Shahbaz Ahmed, Angela Fagerlin, Corey Powell, Marcio Mourao, Emily Chen, Sam Harrison, Jonathan Segal, Khaled Abdel-Kader, Julie Wright Nunes

Abstract read
In one paragraph

Article in Kidney medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–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

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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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

10 authors.

June TomeUniversity of Michigan, Ann Arbor, MI.
Shahbaz AhmedUniversity of Michigan, Ann Arbor, MI.
Angela FagerlinUniversity of Utah and Salt Lake City VA, Salt Lake City, UT.
Corey PowellUniversity of Michigan, Ann Arbor, MI.
Marcio MouraoUniversity of Michigan, Ann Arbor, MI.
Emily ChenUniversity of Michigan, Ann Arbor, MI.
Sam HarrisonUniversity of Michigan, Ann Arbor, MI.
Jonathan SegalUniversity of Michigan, Ann Arbor, MI.
Khaled Abdel-KaderVanderbilt University Medical Center, Nashville, TN.
Julie Wright NunesUniversity of Michigan, Ann Arbor, MI.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

RATIONALE &

objectiveElectronic health record portals are increasingly emphasized in chronic kidney disease (CKD). However, associations of portal use with clinical and patient-centered outcomes remain unknown. STUDY

designCross-sectional survey (April 2015 to March 2018). SETTING &

participantsNondialysis patients with CKD from nephrology clinics within 1 academic medical center. EXPOSURES: Patient demographics (age, sex, race, ethnicity, education, and income), kidney function. OUTCOMES: Association between portal use as an outcome and exposures. Additionally, associations of portal use and patient demographics with 4 patient-centered outcomes (CKD-specific knowledge, stress, and 2 self-ratings of health). ANALYTIC APPROACH: Logistic regression to examine associations between patient portal use, demographics, and kidney function. Linear regression to examine associations between portal use and patient-centered outcomes.

resultsOf 245 participants, mean age was 60 ± 17 (SD) years, 182 (77%) were White, 121 (49%) were women, 230 (96%) had a high school education or higher, and 96 (45%) had <$50,000 annual income. Examining portal use, 159 (65%) used the portal as follows: checking laboratory test results, 157 (99%); managing appointments, 133 (84%); messaging providers, 131 (82%); viewing medical history, 127 (80%); reviewing educational resources, 113 (71%); and renewing prescriptions, 98 (62%). African Americans (OR, 0.34; 95% CI, 0.16-0.72 vs White patients), patients with less formal education (OR, 0.06; 95% CI, 0.01-0.36), and those with lower income (OR, 0.28; 95% CI, 0.13-0.60; and OR, 0.26; 95% CI, 0.12-0.54 comparing income < $25,000 and $25,000-$50,000, respectively, with ≥$50,000) had lower odds of using the portal. In adjusted analysis, only lower income predicted lower portal use. Examining patient-centered outcomes in univariable analysis, portal users had higher knowledge (β = 4.89; LIMITATIONS: Cross-sectional study design, cannot determine causality.

conclusionsInterventions are needed to ensure that all patients have access to portals to mitigate disparities in care.

Indexed as

chronic kidney diseaseinternet usepatient knowledgePatient portalpatient stress

Identifiers

PMID33851118
PMCPMC8039427

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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.