Evidence map›Paper›PMID 37967936›Full record

ArticleApplied clinical informatics2023

Partnering with Patients and Families to Improve Diagnostic Safety through the OurDX Tool: Effects of Race, Ethnicity, and Language Preference.

Fabienne C Bourgeois, Nicholas J Hart, Zhiyong Dong, Long H Ngo, Catherine M DesRoches, Eric J Thomas, Sigall K Bell

Abstract read
In one paragraph

Article in Applied clinical informatics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
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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

7 authors.

Fabienne C BourgeoisDepartment of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, United States.
Nicholas J HartDepartment of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, United States.
Zhiyong DongDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States.
Long H NgoDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States.
Catherine M DesRochesHarvard Medical School, Boston, Massachusetts, United States.
Eric J ThomasDepartment of Medicine, University of Texas at Houston Memorial Hermann Center for Healthcare Quality and Safety, Houston, Texas, United States.
Sigall K BellHarvard Medical School, Boston, Massachusetts, United States.ORCID 0000-0002-9359-6450

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

backgroundPatients and families at risk for health disparities may also be at higher risk for diagnostic errors but less likely to report them.

objectivesThis study aimed to explore differences in race, ethnicity, and language preference associated with patient and family contributions and concerns using an electronic previsit tool designed to engage patients and families in the diagnostic process (DxP).

methodsCross-sectional study of 5,731 patients and families presenting to three subspecialty clinics at an urban pediatric hospital May to December 2021 who completed a previsit tool, codeveloped and tested with patients and families. Prior to each visit, patients/families were invited to share visit priorities, recent histories, and potential diagnostic concerns. We used logistic regression to determine factors associated with patient-reported diagnostic concerns. We conducted chart review on a random subset of visits to review concerns and determine whether patient/family contributions were included in the visit note.

resultsParticipants provided a similar mean number of contributions regardless of patient race, ethnicity, or language preference. Compared with patients self-identifying as White, those self-identifying as Black (odds ratio [OR]: 1.70; 95% confidence interval [CI]: [1.18, 2.43]) or "other" race (OR: 1.48; 95% CI: [1.08, 2.03]) were more likely to report a diagnostic concern. Participants who preferred a language other than English were more likely to report a diagnostic concern than English-preferring patients (OR: 2.53; 95% CI: [1.78, 3.59]. There were no significant differences in physician-verified diagnostic concerns or in integration of patient contributions into the note based on race, ethnicity, or language preference.

conclusionParticipants self-identifying as Black or "other" race, or those who prefer a language other than English were 1.5 to 2.5 times more likely than their counterparts to report potential diagnostic concerns when proactively asked to provide this information prior to a visit. Actively engaging patients and families in the DxP may uncover opportunities to reduce the risk of diagnostic errors and potential safety disparities.

Indexed as

EthnicityLanguageChildCross-Sectional StudiesHumans

Identifiers

PMID37967936
PMCPMC10651368

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LicenceCC BY-NC-ND
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Registered trials

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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.