Evidence map›Paper›PMID 34344396›Full record

ArticlePediatric rheumatology online journal2021

Targeted provider education and pre-visit planning increase rates of formal depression screening in childhood-onset SLE.

Evan Mulvihill, Rebecca Furru, Alana Goldstein-Leever, Kyla Driest, Stephanie Lemle, Darby MacDonald, Emily Frost, Vidya Sivaraman

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric rheumatology online journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 12% 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

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
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  4. Review
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  6. Article
  7. Improving Depression Screening in Adult Patients With Cancer.Journal of the advanced practitioner in oncology · 2024
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Evan MulvihillDepartment of Pediatrics, Divisions of a Rheumatology, Nationwide Children's Hospital and The Ohio State University, Ohio, Columbus, USA. evan.mulvihill@nemours.org.
Rebecca FurruDepartment of Social Work, Nationwide Children's Hospital, The Ohio State University, Ohio, Columbus, USA.
Alana Goldstein-LeeverDepartment of Psychiatry and Behavioral Health, Nationwide Children's Hospital and The Ohio State University, Ohio, Columbus, USA.
Kyla DriestDepartment of Pediatrics, Divisions of a Rheumatology, Nationwide Children's Hospital and The Ohio State University, Ohio, Columbus, USA.
Stephanie LemleDepartment of QI Services, Nationwide Children's Hospital and The Ohio State University, Ohio, Columbus, USA.
Darby MacDonaldDepartment of Pediatrics, Divisions of a Rheumatology, Nationwide Children's Hospital and The Ohio State University, Ohio, Columbus, USA.
Emily FrostDepartment of Pediatrics, Divisions of a Rheumatology, Nationwide Children's Hospital and The Ohio State University, Ohio, Columbus, USA.
Vidya SivaramanDepartment of Pediatrics, Divisions of a Rheumatology, Nationwide Children's Hospital and The Ohio State University, Ohio, Columbus, USA.
Nationwide Children's Hospital · USThe Ohio State University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite being at high risk for depression, patients with childhood-onset systemic lupus erythematosus (c-SLE) are infrequently and inconsistently screened for depression by their pediatric rheumatologists. We aimed to systematically increase rates of formal depression screening for c-SLE patients in an academic Pediatric Rheumatology clinic.

methodsOur multi-disciplinary quality improvement (QI) team used electronic health record (EHR) documentation to retroactively calculate baseline rates of documented depression screening using the Patient Health Questionnaire-9 (PHQ-9). We then engaged key stakeholders to develop a clinical workflow for formal depression screening in the clinic. We also provided education to providers regarding mental health disorders in c-SLE, with an emphasis on prevalence, screening methods, and management of positive screens. We then used the Plan-Do-Study Act (PDSA) method of QI to systematically evaluate and adjust our process in real time. The primary outcome was the percentage of patients with c-SLE seen per month who had a documented PHQ-9 screening within the past year.

resultsThe percentage of children with documented PHQ-9 results ranged from 0 to 4.5 % at baseline to 91.0 % within 12 months of project initiation. By the end of the project, monthly screening rates greater than 80 % has been sustained for 10 months. As a result of these efforts, twenty-seven (48.2 %) patients with at least mild depressive symptoms were identified while seven (12.5 %) with thoughts of self-harm were referred to appropriate mental health resources.

conclusionsRoutine formal depression screening is feasible in a busy subspecialty clinic. Using QI methods, rates of formal depression screening among children with c-SLE were increased from an average of 3.3 % per month to a sustained monthly rate of greater than 80 %. Individuals with depressive symptoms and/or thoughts of self-harm were identified and referred to appropriate mental health resources.

Indexed as

ChildDepressionHumansLupus Erythematosus, SystemicMass ScreeningQuality ImprovementDepression screeningLupusMental healthPHQ-9

Identifiers

PMID34344396
PMCPMC8330037
OpenAlexW3187249867

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.