Evidence map›Paper›PMID 37751941›Full record

ReviewBMJ open quality2023

Reducing hospital admissions in patients with malignant pleural effusion: a quality improvement study.

Rebecca R Cloyes, Enambir Josan, Nicholas Pastis, Jianing Ma, Marilly Palettas, Jing Peng, Susan Vasko-Wood, Chelsea Mohrman, Christian Ghattas, Carolyn Presley and 2 more

Open access · goldAbstract readReview
In one paragraph

Review in BMJ open quality, 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
0.3field-weighted citation impact, top 35% 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

12 authors at 3 institutions in 1 country.

Rebecca R CloyesPulmonary, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA rebecca.cloyes@osumc.edu.ORCID 0000-0003-0270-3036
Enambir JosanPulmonary, The University of Tennessee Medical Center, Knoxville, Tennessee, USA.
Nicholas PastisPulmonary, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Jianing MaBiostatistics, The Ohio State University, Columbus, Ohio, USA.
Marilly PalettasBiostatistics, The Ohio State University, Columbus, Ohio, USA.
Jing PengBiostatistics, The Ohio State University Medical Center, Columbus, Ohio, USA.
Susan Vasko-WoodThe Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Chelsea MohrmanThe Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Christian GhattasThe Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Carolyn PresleyThe Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Alberto ReveloThe Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Jasleen PannuThe Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
The Ohio State University Wexner Medical Center · USThe Ohio State University · USUniversity of Tennessee Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMalignant pleural effusions (MPE) can cause severe dyspnoea leading to greater than 125 000 hospitalisations per year and cost greater than US$5 billion per year in the USA. Timely insertion of tunnelled pleural catheters (TPCs) is associated with fewer inpatient days and emergency department visits. We conducted a quality improvement study to reduce hospital admissions of patients with MPE.

methodsKey stakeholders were surveyed, including thoracic and breast oncology teams, general pulmonary and interventional pulmonology (IP) to help identify the underlying causes and solutions. Our preintervention group consisted of 51 patients who underwent TPC placement by our IP service. In our first intervention, we reviewed referrals for MPE with the scheduling team and triaged them based on urgency. In the second intervention, we added a follow-up phone call 1 week after the initial thoracentesis performed by IP to assess for the recurrence of symptoms.

resultsDemographic and clinical characteristics were summarised across the three groups. We evaluated the rate ratio (RR) of admissions in the intervention groups with the multivariable Poisson regression and adjusted for race, gender and cancer. Compared with the preintervention group, intervention I showed trends towards a 41% lower hospital admission rate (RR 0.59 (0.33-1.07), p=0.11). Compared with the preintervention group, intervention II showed trends towards a 40% lower hospital admission rate (RR 0.6 (0.36-0.99), p=0.07). The results did not reach statistical significance. Exploratory comparisons in readmission rates between interventions I and II showed no difference (RR 0.89 (0.43-1.79), p=0.75).

conclusionsBoth interventions showed trends toward fewer hospital readmissions although they were not statistically significant. Larger-size prospective studies would be needed to demonstrate the continued effectiveness of these interventions.

Indexed as

Pleural Effusion, MalignantHospitalizationHospitalsHumansInpatientsProspective StudiesQuality ImprovementContinuous quality improvementHealthcare quality improvementQuality improvement

Identifiers

PMID37751941
PMCPMC10533796
OpenAlexW4387063620

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.