Evidence map›Paper›PMID 34751653›Full record

ArticleJMIR formative research2021

A Web-Based, Population-Based Cirrhosis Identification and Management System for Improving Cirrhosis Care: Qualitative Formative Evaluation.

Sarah J Javier, Justina Wu, Donna L Smith, Fasiha Kanwal, Lindsey A Martin, Jack Clark, Amanda M Midboe

Open access · goldAbstract read
In one paragraph

Article in JMIR formative research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Perinatal Women's Views of Pharmacist-Delivered Perinatal Depression Screening: A Qualitative Study.International journal of environmental research and public health · 2022
    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 4 institutions in 1 country.

Sarah J JavierCenter for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, United States.ORCID https://orcid.org/0000-0001-8365-8681
Justina WuCenter for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, United States.ORCID https://orcid.org/0000-0003-4806-5260
Donna L SmithCenter for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, United States.ORCID https://orcid.org/0000-0003-1906-666X
Fasiha KanwalCenter for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, United States.ORCID https://orcid.org/0000-0002-1012-8767
Lindsey A MartinNational Institute of Environmental Health Sciences (NIEHS), Division of Extramural Research & Training, Population Health Branch, Research Triangle Park, NC, United States.ORCID https://orcid.org/0000-0002-0075-0640
Jack ClarkDepartment of Health Law, Policy, and Management, School of Public Health, Boston University, Boston, MA, United States.ORCID https://orcid.org/0000-0002-7424-1670
Amanda M MidboeCenter for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, United States.ORCID https://orcid.org/0000-0001-7191-2507
VA Palo Alto Health Care System · USMichael E. DeBakey VA Medical Center · USBoston University · USNational Institute of Environmental Health Sciences · US

Funding

Tissue Analysis & Molecular Imaging CoreP30DK056338 · NIDDK · BAYLOR COLLEGE OF MEDICINE · PI Hashem B El-Serag · 2001 to 2026
$28.3M
NIDDK NIH HHS P30 DK056338
6 · The paper itself

Abstract

backgroundCirrhosis, or scarring of the liver, is a debilitating condition that affects millions of US adults. Early identification, linkage to care, and retention of care are critical for preventing severe complications and death from cirrhosis.

objectiveThe purpose of this study is to conduct a preimplementation formative evaluation to identify factors that could impact implementation of the Population-Based Cirrhosis Identification and Management System (P-CIMS) in clinics serving patients with cirrhosis. P-CIMS is a web-based informatics tool designed to facilitate patient outreach and cirrhosis care management.

methodsSemistructured interviews were conducted between January and May 2016 with frontline providers in liver disease and primary care clinics at 3 Veterans Health Administration medical centers. A total of 10 providers were interviewed, including 8 physicians and midlevel providers from liver-related specialty clinics and 2 primary care providers who managed patients with cirrhosis. The Consolidated Framework for Implementation Research guided the development of the interview guides. Inductive consensus coding and content analysis were used to analyze transcribed interviews and abstracted coded passages, elucidated themes, and insights.

resultsThe following themes and subthemes emerged from the analyses: outer setting: needs and resources for patients with cirrhosis; inner setting: readiness for implementation (subthemes: lack of resources, lack of leadership support), and implementation climate (subtheme: competing priorities); characteristics of individuals: role within clinic; knowledge and beliefs about P-CIMS (subtheme: perceived and realized benefits; useful features; suggestions for improvement); and perceptions of current practices in managing cirrhosis cases (subthemes: preimplementation process for identifying and linking patients to cirrhosis care; structural and social barriers to follow-up). Overall, P-CIMS was viewed as a powerful tool for improving linkage and retention, but its integration in the clinical workflow required leadership support, time, and staffing. Providers also cited the need for more intuitive interface elements to enhance usability.

conclusionsP-CIMS shows promise as a powerful tool for identifying, linking, and retaining care in patients living with cirrhosis. The current evaluation identified several improvements and advantages of P-CIMS over current care processes and provides lessons for others implementing similar population-based identification and management tools in populations with chronic disease.

Indexed as

care coordinationcirrhosisConsolidated Framework for Implementation Research (CFIR)implementationinformaticsquality improvement

Identifiers

PMID34751653
PMCPMC8663449
OpenAlexW3200680840

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.