Evidence map›Paper›PMID 37497577›Full record

ArticlePediatrics2023

Asthma Quality Measurement and Adverse Outcomes in Medicaid-Enrolled Children.

Akilah A Jefferson, Clare C Brown, Arina Eyimina, Anthony Goudie, Mandana Rezaeiahari, Tamara T Perry, J Mick Tilford

Open access · greenAbstract read
In one paragraph

Article in Pediatrics, 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
0.4field-weighted citation impact, top 39% 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, 2 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

7 authors at 2 institutions in 1 country.

Akilah A JeffersonDepartment of Pediatrics, Allergy & Immunology Division.
Clare C BrownCollege of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Arina EyiminaCollege of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Anthony GoudieCollege of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Mandana RezaeiahariCollege of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Tamara T PerryDepartment of Pediatrics, Allergy & Immunology Division.
J Mick TilfordCollege of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
University of Arkansas for Medical Sciences · USArkansas Children's Hospital · US

Funding

Expanding Translational Research in ArkansasUL1TR003107 · NCATS · UNIV OF ARKANSAS FOR MED SCIS · PI JAMES, LAURA P · 2019 to 2023
$21.6M
Institutional Career DevelopmentKL2TR003108 · NCATS · UNIV OF ARKANSAS FOR MED SCIS · PI ARTHUR, JOHN M., BORSHEIM, ELISABET · 2019 to 2023
$2.3M
NCATS NIH HHS KL2 TR003108NCATS NIH HHS UL1 TR003107
6 · The paper itself

Abstract

objectivesTo determine the association between the asthma medication ratio (AMR) quality measure and adverse outcomes among Medicaid-enrolled children with asthma in Arkansas, given concerns regarding the utility of the AMR in evaluating pediatric risk of asthma-related adverse events (AAEs).

methodsWe used the Arkansas All-Payer Claims Database to identify Medicaid-enrolled children with asthma using a nonrestrictive case definition and additionally using the standard Healthcare Effectiveness Data and Information Set (HEDIS) persistent asthma definition. We assessed the AMR using the traditional dichotomous HEDIS AMR categorization and across 4 expanded AMR categories. Regression models assessed associations between AMR and AAE including hospitalization and emergency department utilization, with models conducted overall and by race and ethnicity.

resultsOf the 22 788 children in the analysis, 9.0% had an AAE (6.7% asthma-related emergency department visits; 3.0% asthma-related hospitalizations). We found poor correlation between AMR and AAE, with higher rates of AAE (10.5%) among children with AMR ≥0.5 compared with AMR <0.5 (8.5%; P < .001), and similar patterns stratified by racial and ethnic subgroups. Expanded AMR categorization revealed notable differences in associations between AMR and AAEs, compared with traditional dichotomous categorization, with worse performance in Black children.

conclusionsThe AMR performed poorly in identifying risk of adverse outcomes among Medicaid-enrolled children with asthma. These findings underscore concerns of the utility of the AMR in population health management and reliance on restrictive HEDIS definitions. New population health frameworks incorporating broader considerations that accurately identify at-risk children are needed to improve equity in asthma management and outcomes.

Indexed as

AsthmaMedicaidArkansasChildEmergency Service, HospitalEthnicityHumansUnited States

Identifiers

PMID37497577
PMCPMC10389769
OpenAlexW4385294414

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.