Evidence map›Paper›PMID 34813625›Full record

ArticlePloS one2021

External validation of the PAR-Risk Score to assess potentially avoidable hospital readmission risk in internal medicine patients.

Lukas Higi, Angela Lisibach, Patrick E Beeler, Monika Lutters, Anne-Laure Blanc, Andrea M Burden, Dominik Stämpfli

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
0.5field-weighted citation impact, top 32% 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, 2 syntheses or guidelines pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Risk Factors for Early Hospital Readmission in Geriatric Patients: A Systematic Review.International journal of environmental research and public health · 2023
    Pooled it
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 6 institutions in 1 country.

Lukas HigiDepartment of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.ORCID 0000-0002-9093-4178
Angela LisibachDepartment Medical Services, Clinical Pharmacy, Cantonal Hospital of Baden, Baden, Switzerland.ORCID 0000-0001-8697-492X
Patrick E BeelerDivision of Occupational and Environmental Medicine, Epidemiology, Biostatistics and Prevention Institute, University of Zurich and University Hospital Zurich, Zurich, Switzerland.ORCID 0000-0002-6097-2480
Monika LuttersDepartment Medical Services, Clinical Pharmacy, Cantonal Hospital of Baden, Baden, Switzerland.ORCID 0000-0001-7063-578X
Anne-Laure BlancClinical Pharmacy, Pharmacy of Eastern Vaud Hospitals, Rennaz, Switzerland.ORCID 0000-0002-2295-8290
Andrea M BurdenDepartment of Chemistry and Applied Biosciences, Institue of Pharmaceutical Sciences, Swiss Federal Institute of Technology, Zurich, Switzerland.
Dominik StämpfliDepartment Medical Services, Clinical Pharmacy, Cantonal Hospital of Baden, Baden, Switzerland.ORCID 0000-0001-5293-134X
Kantonsspital Baden · CHÉcole Polytechnique Fédérale de Lausanne · CHPharmacy of the Eastern Vaud Hospitals · CHUniversity of Basel · CHUniversity of Geneva · CHUniversity of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReadmission prediction models have been developed and validated for targeted in-hospital preventive interventions. We aimed to externally validate the Potentially Avoidable Readmission-Risk Score (PAR-Risk Score), a 12-items prediction model for internal medicine patients with a convenient scoring system, for our local patient cohort.

methodsA cohort study using electronic health record data from the internal medicine ward of a Swiss tertiary teaching hospital was conducted. The individual PAR-Risk Score values were calculated for each patient. Univariable logistic regression was used to predict potentially avoidable readmissions (PARs), as identified by the SQLape algorithm. For additional analyses, patients were stratified into low, medium, and high risk according to tertiles based on the PAR-Risk Score. Statistical associations between predictor variables and PAR as outcome were assessed using both univariable and multivariable logistic regression.

resultsThe final dataset consisted of 5,985 patients. Of these, 340 patients (5.7%) experienced a PAR. The overall PAR-Risk Score showed rather poor discriminatory power (C statistic 0.605, 95%-CI 0.575-0.635). When using stratified groups (low, medium, high), patients in the high-risk group were at statistically significant higher odds (OR 2.63, 95%-CI 1.33-5.18) of being readmitted within 30 days compared to low risk patients. Multivariable logistic regression identified previous admission within six months, anaemia, heart failure, and opioids to be significantly associated with PAR in this patient cohort.

conclusionThis external validation showed a limited overall performance of the PAR-Risk Score, although higher scores were associated with an increased risk for PAR and patients in the high-risk group were at significantly higher odds of being readmitted within 30 days. This study highlights the importance of externally validating prediction models.

Indexed as

AdultAgedAlgorithmsCohort StudiesElectronic Health RecordsFemaleForecastingHospitalizationHumansInternal MedicineLogistic ModelsMaleMiddle AgedPatient ReadmissionRisk FactorsSwitzerland

Identifiers

PMID34813625
PMCPMC8610256
OpenAlexW3214845062

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.