Evidence map›Paper›PMID 34846805›Full record

Trial reportMusculoskeletal care2022

Digital medical history implementation to triage orthopaedic patients during COVID-19: Findings from a rapid cycle, semi-randomised A/B testing quality improvement project.

David N Bernstein, Victor A van de Graaf, Irina Meijers, Anne Portengen, Amanda Klaassen, Vanessa A B Scholtes, Rudolf W Poolman, Diederik H R Kempen

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Musculoskeletal care, 2022. 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
–field-weighted citation impact
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.

  1. Trial
  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

8 authors.

David N BernsteinDepartment of Orthopaedic Surgery, Harvard Combined Orthopaedic Residency Program (HCORP), Massachusetts General Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-1784-3288
Victor A van de GraafDepartment of Orthopaedic Surgery, Joint Research, OLVG Amsterdam, Amsterdam, The Netherlands.
Irina MeijersDepartment of Orthopaedic Surgery, Joint Research, OLVG Amsterdam, Amsterdam, The Netherlands.
Anne PortengenDepartment of Orthopaedic Surgery, Joint Research, OLVG Amsterdam, Amsterdam, The Netherlands.
Amanda KlaassenDepartment of Orthopaedic Surgery, Joint Research, OLVG Amsterdam, Amsterdam, The Netherlands.
Vanessa A B ScholtesDepartment of Orthopaedic Surgery, Joint Research, OLVG Amsterdam, Amsterdam, The Netherlands.
Rudolf W PoolmanDepartment of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Diederik H R KempenDepartment of Orthopaedic Surgery, Joint Research, OLVG Amsterdam, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe COVID-19 pandemic severely impacted musculoskeletal care. To better triage the notable backlog of patients, we assessed whether a digital medical history (DMH), a summary of health information and concerns completed by the patient prior to a clinic visit, could be routinely collected and utilised.

methodsWe analysed 640 patients using a rapid cycle, semi-randomised A/B testing approach. Four rapid cycles of different randomised interventions were conducted across five unique patient groups. Descriptive statistics were used to report DMH completion rates by cycle/patient group and intervention. Multivariable logistic regression was used to determine whether age or anatomic injury location was associated DMH completion. ETHICAL APPROVAL: N/A (Quality Improvement Project)

resultsAcross all patients, the DMH completion rate was 48% (307/640). Phone calls were time consuming and resource intensive without an increased completion rate. The highest rate of DMH completion was among patients who were referred and called the clinic themselves (78% of patients [63 out of 81 patients]). Across all patients, increasing age (odds ratio [OR]: 0.985 (95% CI: 0.976-0.995), p = 0.002), patients with back concerns (OR: 0.395 (95% CI: 0.234-0.666), p = 0.001), and patients with non-specific/other musculoskeletal concerns (OR: 0.331 (95% CI: 0.176-0.623), p = 0.001) were associated with decreased odds of DMH completion. DISCUSSION AND

conclusionDMHs can be valuable in helping triage orthopaedic patients in resource-strapped settings, times of crisis, or as we transition towards value-based health care delivery. However, further work is needed to continue to increase the completion rate about 50%.

Indexed as

COVID-19Medical History TakingOrthopedicsHumansPandemicsQuality ImprovementTriageCOVID-19digital medical historyhealth care transformationvalue-based health care

Identifiers

PMID34846805
PMCPMC9015220

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Registered trials

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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.