Evidence map›Paper›PMID 36894892›Full record

ReviewBMC geriatrics2023

Using electronic consultation (eConsult) to identify frailty in provider-to-provider communication: a feasibility and validation study.

Ramtin Hakimjavadi, Sathya Karunananthan, Celeste Fung, Cheryl Levi, Mary Helmer-Smith, James LaPlante, Mohamed Gazarin, Arya Rahgozar, Amir Afkham, Erin Keely and 1 more

Open access · goldAbstract readReview
In one paragraph

Review in BMC geriatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 53% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

11 authors at 5 institutions in 3 countries.

Ramtin HakimjavadiFaculty of Medicine, University of Ottawa, Ottawa, Canada.
Sathya KarunananthanC.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada.
Celeste FungDepartment of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
Cheryl LeviEmergency Department Outreach Program, The Ottawa Hospital, Ottawa, Canada.
Mary Helmer-SmithSchool of Population and Public Health, Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada.
James LaPlanteC.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada.
Mohamed GazarinCentre of Excellence for Rural Health and Education, Winchester District Memorial Hospital, Winchester, Ontario, Canada.
Arya RahgozarDepartment of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
Amir AfkhamOntario Health East, Ottawa, Canada.
Erin KeelyOntario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Canada.
Clare LiddyC.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada. cliddy@uottawa.ca.
University of Ottawa · CAOttawa Hospital · CABruyère · CAUniversity of British Columbia · CAWinchester Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFrailty is a complex age-related clinical condition that increases vulnerability to stressors. Early recognition of frailty is challenging. While primary care providers (PCPs) serve as the first point of contact for most older adults, convenient tools for identifying frailty in primary care are lacking. Electronic consultation (eConsult), a platform connecting PCPs to specialists, is a rich source of provider-to-provider communication data. Text-based patient descriptions on eConsult may provide opportunities for earlier identification of frailty. We sought to explore the feasibility and validity of identifying frailty status using eConsult data.

methodseConsult cases closed in 2019 and submitted on behalf of long-term care (LTC) residents or community-dwelling older adults were sampled. A list of frailty-related terms was compiled through a review of the literature and consultation with experts. To identify frailty, eConsult text was parsed to measure the frequency of frailty-related terms. Feasibility of this approach was assessed by examining the availability of frailty-related terms in eConsult communication logs, and by asking clinicians to indicate whether they can assess likelihood of frailty by reviewing the cases. Construct validity was assessed by comparing the number of frailty-related terms in cases about LTC residents with those about community-dwelling older adults. Criterion validity was assessed by comparing clinicians' ratings of frailty to the frequency of frailty-related terms.

resultsOne hundred thirteen LTC and 112 community cases were included. Frailty-related terms identified per case averaged 4.55 ± 3.95 in LTC and 1.96 ± 2.68 in the community (p < .001). Clinicians consistently rated cases with ≥ 5 frailty-related terms as highly likely of living with frailty.

conclusionsThe availability of frailty-related terms establishes the feasibility of using provider-to-provider communication on eConsult to identify patients with high likelihood of living with this condition. The higher average of frailty-related terms in LTC (versus community) cases, and agreement between clinician-provided frailty ratings and the frequency of frailty-related terms, support the validity of an eConsult-based approach to identifying frailty. There is potential for eConsult to be used as a case-finding tool in primary care for early recognition and proactive initiation of care processes for older patients living with frailty.

Indexed as

FrailtyRemote ConsultationAgedCommunicationFeasibility StudiesHealth Services AccessibilityHumansPrimary Health CareReferral and ConsultationElectronic consultationFrailtyIdentificationTelemedicineUnstructured data

Identifiers

PMID36894892
PMCPMC9999527
OpenAlexW4323669600

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.