Evidence map›Paper›PMID 34345748›Full record

ArticlePediatric quality & safety

Testing the Use of Data Drawn from the Electronic Health Record to Compare Quality.

Kathleen E Walsh, Hanieh Razzaghi, David M Hartley, Levon Utidjian, Shannon Alford, Rahul A Darwar, Elizabeth Shenkman, Susannah Jonas, Mary Goodick, Jonathan Finkelstein and 10 more

Open access · diamondAbstract read
In one paragraph

Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 17% 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, 7 citations in OpenAlex.

  1. Article
  2. Article
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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

20 authors at 6 institutions in 1 country.

Kathleen E WalshBoston Children's Hospital, Boston, Mass.
Hanieh RazzaghiDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pa.
David M HartleyJames M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital, Cincinnati, Ohio.
Levon UtidjianDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pa.
Shannon AlfordDepartment of Health Outcomes and Biomedical Informatics, University of Florida, College of Medicine, Gainesville, Fla.
Rahul A DarwarDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pa.
Elizabeth ShenkmanDepartment of Health Outcomes and Biomedical Informatics, University of Florida, College of Medicine, Gainesville, Fla.
Susannah JonasJames M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital, Cincinnati, Ohio.
Mary GoodickJames M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital, Cincinnati, Ohio.
Jonathan FinkelsteinBoston Children's Hospital, Boston, Mass.
Al OzonoffBoston Children's Hospital, Boston, Mass.
L Vandy BlackDivision of Pediatric Hematology and Oncology, University of Florida College of Medicine, Gainesville, Nicklaus Children's Hospital, Miami, Fla.
Michael ShapiroDepartment of Psychiatry, University of Florida College of Medicine, Gainesville, Fla.
Kathryn ShawDepartment of Health Outcomes and Biomedical Informatics, University of Florida, College of Medicine, Gainesville, Fla.
Jennifer McCafferty-FernandezNicklaus Children's Health System, Miami, Fla.
Keith MarsoloDepartment of Population Health Sciences, Duke University School of Medicine, Durham, N.C.
Amy KellyDevereux Advanced Behavioral Health, Berwyn, Pa.
Lloyd N WerkDivision of General Academic Pediatrics, Nemours Children's Hospital, Orlando, Fla.
Jordan SmallwoodDivision of Allergy-Immunology, Nemours Children's Hospital, Orlando, Fla.
Charles BaileyDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pa.
Children's Hospital of Philadelphia · USCincinnati Children's Hospital Medical Center · USBoston Children's Hospital · USBoston Children's Museum · USHarvard University · USWalsh University · US

Funding

Using social networks to map and evaluate team science across CTSA hubsUL1TR001427 · NCATS · UNIVERSITY OF FLORIDA · PI MITCHELL, DUANE A. · 2015 to 2024
$37.2M
NCATS NIH HHS UL1 TR001427
6 · The paper itself

Abstract

introductionHealth systems spend $1.5 billion annually reporting data on quality, but efficacy and utility for benchmarking are limited due, in part, to limitations of data sources. Our objective was to implement and evaluate measures of pediatric quality for three conditions using electronic health record (EHR)-derived data.

methodsPCORnet networks standardized EHR-derived data to a common data model. In 13 health systems from 2 networks for 2015, we implemented the National Quality Forum measures: % children with sickle cell anemia who received a transcranial Doppler; % children on antipsychotics who had metabolic screening; and % pediatric acute otitis media with amoxicillin prescribed. Manual chart review assessed measure accuracy.

resultsOnly 39% (N = 2,923) of 7,278 children on antipsychotics received metabolic screening (range: 20%-54%). If the measure indicated screening was performed, the chart agreed 88% of the time [95% confidence interval (CI): 81%-94%]; if it indicated screening was not done, the chart agreed 86% (95% CI: 78%-93%). Only 69% (N = 793) of 1,144 children received transcranial Doppler screening (range across sites: 49%-88%). If the measure indicated screening was performed, the chart agreed 98% of the time (95% CI: 94%-100%); if it indicated screening was not performed, the chart agreed 89% (95% CI: 82%-95%). For acute otitis media, chart review identified many qualifying cases missed by the National Quality Forum measure, which excluded a common diagnostic code.

conclusionsMeasures of healthcare quality developed using EHR-derived data were valid and identified wide variation among network sites. This data can facilitate the identification and spread of best practices.

Identifiers

PMID34345748
PMCPMC8322494
OpenAlexW3187066543

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.