Evidence map›Paper›PMID 34290041›Full record

ArticleHospital pediatrics2021

Validation of an Automated System for Identifying Complications of Serious Pediatric Emergencies.

Kenneth A Michelson, Arianna H Dart, Jonathan A Finkelstein, Richard G Bachur

Open access · greenAbstract read
In one paragraph

Article in Hospital pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 28% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. 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

4 authors at 1 institution in 1 country.

Kenneth A MichelsonDivisions of Emergency Medicine kenneth.michelson@childrens.harvard.edu.
Arianna H DartDivisions of Emergency Medicine.
Jonathan A FinkelsteinGeneral Pediatrics, Boston Children's Hospital, Boston, Massachusetts, United States.
Richard G BachurDivisions of Emergency Medicine.
Boston Children's Hospital · US

Funding

Delayed Diagnosis of Serious Pediatric Emergency ConditionsK08HS026503 · AHRQ · LURIE CHILDREN'S HOSPITAL OF CHICAGO · PI MICHELSON, KENNETH · 2019 to 2023
$763k
AHRQ HHS K08 HS026503
6 · The paper itself

Abstract

backgroundIllness complications are condition-specific adverse outcomes. Detecting complications of pediatric illness in administrative data would facilitate widespread quality measurement, however the accuracy of such detection is unclear.

methodsWe conducted a cross-sectional study of patients visiting a large pediatric emergency department. We analyzed those <22 years old from 2012 to 2019 with 1 of 14 serious conditions: appendicitis, bacterial meningitis, diabetic ketoacidosis (DKA), empyema, encephalitis, intussusception, mastoiditis, myocarditis, orbital cellulitis, ovarian torsion, sepsis, septic arthritis, stroke, and testicular torsion. We applied a method using disposition, diagnosis codes, and procedure codes to identify complications. The automated determination was compared with the criterion standard of manual health record review by using positive predictive values (PPVs) and negative predictive values (NPVs). Interrater reliability of manual reviews used a κ.

resultsWe analyzed 1534 encounters. PPVs and NPVs for complications were >80% for 8 of 14 conditions: appendicitis, bacterial meningitis, intussusception, mastoiditis, myocarditis, orbital cellulitis, sepsis, and testicular torsion. Lower PPVs for complications were observed for DKA (57%), empyema (53%), encephalitis (78%), ovarian torsion (21%), and septic arthritis (64%). A lower NPV was observed in stroke (68%). The κ between reviewers was 0.88.

conclusionsAn automated method to measure complications by using administrative data can detect complications in appendicitis, bacterial meningitis, intussusception, mastoiditis, myocarditis, orbital cellulitis, sepsis, and testicular torsion. For DKA, empyema, encephalitis, ovarian torsion, septic arthritis, and stroke, the tool may be used to screen for complicated cases that may subsequently undergo manual review.

Indexed as

AppendicitisEmergenciesAdultChildCross-Sectional StudiesEmergency Service, HospitalHumansReproducibility of ResultsYoung Adult

Identifiers

PMID34290041
PMCPMC8651277
OpenAlexW3183898230

What OpenQuestion holds

Textmetadata
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.