Evidence map›Paper›PMID 36660313›Full record

ArticleJournal of the American College of Emergency Physicians open2023

Examining the utility and accuracy of the interRAI Emergency Department Screener in identifying high-risk older emergency department patients: A Canadian multiprovince prospective cohort study.

Fabrice I Mowbray, George Heckman, John P Hirdes, Andrew P Costa, Olivier Beauchet, Debra Eagles, Jeffrey J Perry, Samir Sinha, Patrick Archambault, Hanting Wang and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American College of Emergency Physicians open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. 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

12 authors.

Fabrice I MowbrayDepartment of Health Research Methods, Evidence, and Impact McMaster University Hamilton Ontario Canada.
George HeckmanSchool of Public Health Science University of Waterloo Waterloo Ontario Canada.
John P HirdesSchool of Public Health Science University of Waterloo Waterloo Ontario Canada.
Andrew P CostaDepartment of Health Research Methods, Evidence, and Impact McMaster University Hamilton Ontario Canada.
Olivier BeauchetDepartments of Medicine and Research Center of the Geriatric University Institute of Montreal University of Montreal Montreal Quebec Canada.
Debra EaglesDepartment of Emergency Medicine School of Epidemiology and Public Health University of Ottawa Ottawa Ontario Canada.
Jeffrey J PerryDepartment of Emergency Medicine School of Epidemiology and Public Health University of Ottawa Ottawa Ontario Canada.
Samir SinhaDepartment of Medicine Division of Geriatric Medicine Sinai Health and University Health Network Toronto Ontario Canada.
Patrick ArchambaultDepartment of Family Medicine and Emergency Medicine Université Laval Québec City Ontario Canada.
Hanting WangDepartment of Medicine Division of Critical Care Medicine Universite de Montreal Montreal Quebec Canada.
Michaela JantziSchool of Public Health Science University of Waterloo Waterloo Ontario Canada.
Paul HebertDepartment of Medicine Division of Palliative Care Bruyere Research Institute University of Ottawa Ottawa Ontario Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: We set out to determine the accuracy of the interRAI Emergency Department (ED) Screener in predicting the need for detailed geriatric assessment in the ED. Our secondary objective was to determine the discriminative ability of the interRAI ED Screener for predicting the odds of discharge home and extended ED length of stay (>24 hours). Methods: We conducted a multiprovince prospective cohort study in Canada. The need for detailed geriatric assessment was determined using the interRAI ED Screener and the interRAI ED Contact Assessment as the reference standard. A score of ≥5 was used to classify high-risk patients. Assessments were conducted by emergency and research nurses. We calculated the sensitivity, positive predictive value, and false discovery rate of the interRAI ED Screener. We employed logistic regression to predict ED outcomes while adjusting for age, sex, academic status, and the province of care. Results: A total of 5629 older ED patients across 11 ED sites were evaluated using the interRAI ED Screener and 1061 were evaluated with the interRAI ED Contact Assessment. Approximately one-third of patients were discharged home or experienced an extended ED length of stay. The interRAI ED Screener had a sensitivity of 93%, a positive predictive value of 82%, and a false discovery rate of 18%. The interRAI ED Screener predicted discharge home and extended ED length of stay with fair accuracy. Conclusion: The interRAI ED Screener is able to accurately and rapidly identify individuals with medical complexity. The interRAI ED Screener predicts patient-important health outcomes in older ED patients, highlighting its value for vulnerability screening.

Indexed as

emergency departmentfrailtygeriatricsinterRAIscreeningvulnerability

Identifiers

PMID36660313
PMCPMC9838565

What OpenQuestion holds

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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.