Evidence map›Paper›PMID 36750578›Full record

ArticleNPJ primary care respiratory medicine2023

The feasibility and impact of implementing a computer-guided consultation to target health inequality in Asthma.

B Chakrabarti, B Kane, C Barrow, J Stonebanks, L Reed, M G Pearson, L Davies, M Osborne, P England, D Litchfield and 2 more

Open access · goldAbstract read
In one paragraph

Article in NPJ primary care respiratory medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.6field-weighted citation impact, top 18% 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

4 citing papers in PubMed, 9 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

12 authors at 2 institutions in 1 country.

B ChakrabartiLiverpool University Hospitals NHS Foundation Trust, Liverpool, UK. biz@doctors.org.uk.ORCID 0000-0002-0433-1785
B KaneHealth Innovation Manchester, Manchester, UK.
C BarrowHealth Innovation Manchester, Manchester, UK.
J StonebanksHealth Innovation Manchester, Manchester, UK.
L ReedLungHealth Ltd, Swaffham, UK.
M G PearsonLungHealth Ltd, Swaffham, UK.
L DaviesLiverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
M OsborneLungHealth Ltd, Swaffham, UK.
P EnglandLungHealth Ltd, Swaffham, UK.
D LitchfieldLungHealth Ltd, Swaffham, UK.
E McKnightLungHealth Ltd, Swaffham, UK.
R M AngusLiverpool University Hospitals NHS Foundation Trust, Liverpool, UK.ORCID 0000-0001-5987-5598
Health Innovation Manchester · GBUniversity of Liverpool · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Greater Manchester has a greater prevalence and worse asthma outcomes than the national average. This study aims to evaluate a digital approach to primary care asthma management and in particular the initial impact of implementing Clinical Decision Support System software in the form of a computer-guided consultation (CGC) in the setting of primary care asthma reviews in deprived areas of Greater Manchester. The CGC (LungHealth Ltd) is an intelligent decision support system ensuring accurate guideline-based staging of asthma and assessment of asthma control with the software subsequently prompting guideline-standard management. Patients on asthma registers in Greater Manchester Primary Care Networks were identified and underwent remote review by nursing staff using the CGC linked directly to the GP clinical system. Three-hundred thirty-eight patients (mean age 59 (SD 17) years; 60% Female) were reviewed. The CGC reported the patient's asthma control to be "Good" in 22%, "Partial" in 6% and "Poor" in 72%. ACT scores were significantly higher in those patients exhibiting "Good" and "Partial" control when compared to those with "Poor" control. The number of steroid courses and hospital admissions in the previous 12 months was significantly lower in those patients exhibiting "Good" and "Partial" control when compared to those with "Poor" control. Nineteen percent were found not to have a personalised asthma management plan during CGC review, which was alerted by the CGC and subsequently, all but 3 patients had this created on review completion (McNemar's test; p < 0.001). 5% were found not to have been prescribed regular inhaled steroid therapy resulting in the operator being alerted by the CGC in all cases. Overall, 44% underwent alteration in asthma therapy following the CGC review with 82% of these representing treatment escalation. An end-to-end digital service solution is feasible for Asthma within primary care and the utilisation of a CGC when conducting primary care asthma reviews increases implementation of guideline-level management thus addressing healthcare inequality while enabling identification of "high risk" asthma patients and guiding appropriate therapy escalation and de-escalation.

Indexed as

AsthmaHealth Status DisparitiesComputersFeasibility StudiesFemaleHumansMaleMiddle AgedReferral and Consultation

Identifiers

PMID36750578
PMCPMC9903267
OpenAlexW4319437543

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.