Evidence map›Paper›PMID 34476304›Full record

ArticlePediatric quality & safety

Complex Care Program Enrollment and Change in ED and Hospital Visits from Medical Device Complications.

Christina B Barreda, Mary L Ehlenbach, Allison Nackers, Michelle M Kelly, Kristin A Shadman, Daniel J Sklansky, M Bruce Edmonson, Qianqian Zhao, Gemma Warner, Ryan J Coller

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
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 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 8% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
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 at 1 institution in 1 country.

Christina B BarredaDepartment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Mary L EhlenbachDepartment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Allison NackersDepartment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Michelle M KellyDepartment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Kristin A ShadmanDepartment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Daniel J SklanskyDepartment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
M Bruce EdmonsonDepartment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Qianqian ZhaoDepartment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Gemma WarnerDepartment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Ryan J CollerDepartment of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
University of Wisconsin–Madison · US

Funding

University of Wisconsin Institute for Clinical and Translational ResearchUL1TR002373 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI ELIZABETH S BURNSIDE, Allan R. Brasier · 2017 to 2026
$75.9M
NCATS NIH HHS UL1 TR002373
6 · The paper itself

Abstract

introductionMedical device-related complications often lead to emergency department (ED) visits and hospitalizations for children with medical complexity (CMC), and pediatric complex care programs may be one way to decrease unnecessary encounters.

methodsA retrospective cohort study comparing ED and inpatient encounters due to device complications of 2 cohorts of CMC at a single children's hospital during 2014-2016; 99 enrolled in a complex care program and 244 in a propensity-matched comparison group. Structured chart reviews identified ED and inpatient encounters due to device complications. The outcome was a change in the frequency of these encounters from the year before to the year after enrollment in the hospital's complex care program. Program effects were estimated with weighted difference-in-differences (DiDs), comparing the change in mean encounter frequency for CMC enrolled in the program with change for propensity-matched children not enrolled in the program.

resultsMean encounters related to device complications decreased for both groups. Complication-related ED encounters per year decreased from a weighted mean (SD) of 0.74 (0.85) to 0.30 (0.44) in enrolled children and 0.26 (0.89) to 0.12 (0.56) in comparison children, a DiD of 0.30 fewer [95% confidence interval (CI) -0.01 to 0.60]. The largest reductions in device complication ED visits were among those with enteral tubes [0.36 fewer (95% CI 0.04-0.68)]. Hospitalizations decreased over time, but DiDs were not significantly different between groups.

conclusionsAcute care use from device complications decreased with time. Complex care program enrollment may be associated with more substantial reductions in device complication ED visits, and effects may be most pronounced for CMC with enteral tubes.

Identifiers

PMID34476304
PMCPMC8389945
OpenAlexW3197167856

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.