Evidence map›Paper›PMID 34464890›Full record

Observational studyThe Journal of surgical research2021

Outcomes after a Digital Behavior Change Intervention to Improve Trauma Triage: An Analysis of Medicare Claims.

Deepika Mohan, Chung-Chou Chang, Baruch Fischhoff, Matthew R Rosengart, Derek C Angus, Donald M Yealy, Amber E Barnato

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in The Journal of surgical research, 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
1.5field-weighted citation impact, top 18% 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, 7 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

7 authors at 3 institutions in 1 country.

Deepika MohanDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania,. Electronic address: mohand@upmc.edu.
Chung-Chou ChangDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Baruch FischhoffDepartment of Engineering and Environmental Policy, Carnegie Mellon University, Pittsburgh, Pennsylvania.
Matthew R RosengartDepartment of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Derek C AngusDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Donald M YealyDepartment of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Amber E BarnatoThe Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
University of Pittsburgh · USCarnegie Mellon University · USDartmouth Institute for Health Policy and Clinical Practice · US

Funding

A novel intervention to make heuristics a source of power for physiciansDP2LM012339 · NLM · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI MOHAN, DEEPIKA · 2015 to 2015
$2.3M
NLM NIH HHS DP2 LM012339
6 · The paper itself

Abstract

backgroundUnder-triage in trauma remains prevalent, in part because of decisions made by physicians at non-trauma centers. We developed two digital behavior change interventions to recalibrate physician heuristics (pattern recognition), and randomized 688 emergency medicine physicians to use the interventions or to a control. In this observational follow-up, we evaluated whether exposure to the interventions changed physician performance in practice.

methodsWe obtained 2016 - 2018 Medicare claims for severely injured patients, linked the names of trial participants to National Provider Identifiers (NPIs), and identified claims filed by trial participants for injured patients presenting to non-trauma centers in the year before and after their trial. The primary outcome measure was the triage status of severely injured patients.

resultsWe linked 670 (97%) participants to NPIs, identified claims filed for severely injured patients by 520 (76%) participants, and claims filed at non-trauma centers by 228 (33%). Most participants were white (64%), male (67%), and had more than three years of experience (91%). Patients had a median Injury Severity Score of 16 (IQR 16 - 17), and primarily sustained neuro-trauma. After adjustment, patients treated by physicians randomized to the interventions experienced less under-triage in the year after the trial than before (41% versus 58% [-17%], P = 0.015); patients treated by physicians randomized to the control experienced no difference in under-triage (49% versus 56% [-7%], P = 0.35). The difference-in-the-difference was non-significant (10%, P = 0.18).

conclusionsIt was feasible to track trial participants' performance in national claims. Sample size limitations constrained causal inference about the effect of the interventions.

Indexed as

Emergency MedicineWounds and InjuriesAgedFemaleHumansInjury Severity ScoreMaleMedicareRetrospective StudiesTrauma CentersTriageUnited StatesDigital behavior change interventionsGuidelinesPhysician performanceTrauma triage

Identifiers

PMID34464890
PMCPMC8678167
OpenAlexW3198676581

What OpenQuestion holds

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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.