Evidence map›Paper›PMID 34986493›Full record

ArticleApplied clinical informatics2022

Effect of Replacing Vendor QTc Alerts with a Custom QTc Risk Alert in Inpatients.

Steven Stettner, Sarah Adie, Sarah Hanigan, Michael Thomas, Kristen Pogue, Christopher Zimmerman

Open access · bronzeAbstract read
In one paragraph

Article in Applied clinical informatics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.3field-weighted citation impact, top 22% 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, 6 citations in OpenAlex.

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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

6 authors at 3 institutions in 1 country.

Steven StettnerDepartment of Pharmacy, New York-Presbyterian/Weill Cornell Medical Center, New York, New York, United States.
Sarah AdieDepartment of Pharmacy Services, Michigan Medicine, Ann Arbor, Michigan, United States.
Sarah HaniganDepartment of Pharmacy Services, Michigan Medicine, Ann Arbor, Michigan, United States.
Michael ThomasDepartment of Internal Medicine-Cardiology, Michigan Medicine, Ann Arbor, Michigan, United States.
Kristen PogueDepartment of Pharmacy Services, Michigan Medicine, Ann Arbor, Michigan, United States.
Christopher ZimmermanDepartment of Health Information and Technology Services, Michigan Medicine, Ann Arbor, Michigan, United States.
Michigan United · USCornell University · USMichigan Medicine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of the study is to implement a customized QTc interval clinical decision support (CDS) alert strategy in our electronic health record for hospitalized patients and aimed at providers with the following objectives: minimize QTc prolongation, minimize exposure to QTc prolonging medications, and decrease overall QTc-related alerts. A strategy that was based on the validated QTc risk scoring tool and replacing medication knowledge vendor alerts with custom QTc prolongation alerts was implemented.

methodsThis is a retrospective quasi-experimental study with a pre-intervention period (August 2019 to October 2019) and post-intervention period (December 2019 to February 2020). The custom alert was implemented in November 2019.

resultsIn the pre-implementation group, 361 (19.3%) patients developed QTc prolongation, and in the post-implementation group, 357 (19.6%) patients developed QTc prolongation (OR: 1.02, 95% CI: 0.87-1.20,

conclusionWe were able to decrease patient exposure to QTc prolonging medications while not increasing the rate of QTc prolongation as well as improving alert action rate. Additionally, there was a decrease in QTc prolonging medication orders which illustrates the benefit of using a validated risk score with a customized CDS approach compared with a traditional vendor-based strategy. Further research is needed to confirm if an approach implemented at our organization can reduce QTc prolongation rates.

Indexed as

Decision Support Systems, ClinicalLong QT SyndromeHumansInpatientsRetrospective StudiesRisk Factors

Identifiers

PMID34986493
PMCPMC8731239
OpenAlexW4206163326

What OpenQuestion holds

Textmetadata
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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.