Evidence map›Paper›PMID 36692204›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2023

Partnering with patients and families living with chronic conditions to coproduce diagnostic safety through OurDX: a previsit online engagement tool.

Sigall K Bell, Zhiyong J Dong, Catherine M Desroches, Nicholas Hart, Stephen Liu, Brianna Mahon, Long H Ngo, Eric J Thomas, Fabienne Bourgeois

Open access · greenAbstract read
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
3.1field-weighted citation impact, top 8% 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

6 citing papers in PubMed, 12 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

9 authors at 4 institutions in 1 country.

Sigall K BellDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0002-9359-6450
Zhiyong J DongDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Catherine M DesrochesDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Nicholas HartDepartment of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Stephen LiuDepartment of Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
Brianna MahonDepartment of Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
Long H NgoDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Eric J ThomasDepartment of Medicine, UT Houston-Memorial Hermann Center for Healthcare Quality and Safety, Houston, Texas, USA.
Fabienne BourgeoisDepartment of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Beth Israel Deaconess Medical Center · USBoston Children's Hospital · USDartmouth College · USMemorial Hermann · US

Funding

Answering the call to engage patients and families in the diagnostic process: A new patient-centered approach using health information transparency to identify diagnostic breakdowns in ambulatory careR01HS027367 · AHRQ · BETH ISRAEL DEACONESS MEDICAL CENTER · PI BELL, SIGALL · 2019 to 2021
$1.5M
AHRQ HHS R01 HS027367
6 · The paper itself

Abstract

objectivePatients and families are key partners in diagnosis, but methods to routinely engage them in diagnostic safety are lacking. Policy mandating patient access to electronic health information presents new opportunities. We tested a new online tool ("OurDX") that was codesigned with patients and families, to determine the types and frequencies of potential safety issues identified by patients/families with chronic health conditions and whether their contributions were integrated into the visit note.

methodsPatients/families at 2 US healthcare sites were invited to contribute, through an online previsit survey: (1) visit priorities, (2) recent medical history/symptoms, and (3) potential diagnostic concerns. Two physicians reviewed patient-reported diagnostic concerns to verify and categorize diagnostic safety opportunities (DSOs). We conducted a chart review to determine whether patient contributions were integrated into the note. We used descriptive statistics to report implementation outcomes, verification of DSOs, and chart review findings.

resultsParticipants completed OurDX reports in 7075 of 18 129 (39%) eligible pediatric subspecialty visits (site 1), and 460 of 706 (65%) eligible adult primary care visits (site 2). Among patients reporting diagnostic concerns, 63% were verified as probable DSOs. In total, probable DSOs were identified by 7.5% of pediatric and adult patients/families with underlying health conditions, respectively. The most common types of DSOs were patients/families not feeling heard; problems/delays with tests or referrals; and problems/delays with explanation or next steps. In chart review, most clinician notes included all or some patient/family priorities and patient-reported histories.

conclusionsOurDX can help engage patients and families living with chronic health conditions in diagnosis. Participating patients/families identified DSOs and most of their OurDX contributions were included in the visit note.

Indexed as

Delivery of Health CarePatientsAdultChildEmotionsHealth FacilitiesHumansProbabilitycommunicationdiagnosisdiagnostic errorelectronic health recordpatient engagementpatient safety

Identifiers

PMID36692204
PMCPMC10018262
OpenAlexW4317866740

What OpenQuestion holds

Textmetadata
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.