Evidence map›Paper›PMID 38283749›Full record

ArticleFrontiers in endocrinology2023

Process analysis of the patient pathway for automated data collection: an exemplar using pituitary surgery.

John G Hanrahan, Alexander W Carter, Danyal Z Khan, Jonathan P Funnell, Simon C Williams, Neil L Dorward, Stephanie E Baldeweg, Hani J Marcus

Open access · goldAbstract read
In one paragraph

Article in Frontiers in endocrinology, 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
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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. 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

8 authors at 4 institutions in 1 country.

John G HanrahanDepartment of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
Alexander W CarterDepartment of Health Policy, London School of Economics & Political Science, London, United Kingdom.
Danyal Z KhanDepartment of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
Jonathan P FunnellWellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom.
Simon C WilliamsWellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom.
Neil L DorwardDepartment of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
Stephanie E BaldewegDepartment of Diabetes & Endocrinology, University College London Hospitals National Health Service (NHS) Foundation Trust, London, United Kingdom.
Hani J MarcusDepartment of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
University College London · GBLondon School of Economics and Political Science · GBSt George's Hospital · GBWellcome / EPSRC Centre for Interventional and Surgical Sciences · GB

Funding

Cancer Research UKWellcome TrustWellcome Trust 203145Z/16/Z
6 · The paper itself

Abstract

Introduction: Automation of routine clinical data shows promise in relieving health systems of the burden associated with manual data collection. Identifying consistent points of documentation in the electronic health record (EHR) provides salient targets to improve data entry quality. Using our pituitary surgery service as an exemplar, we aimed to demonstrate how process mapping can be used to identify reliable areas of documentation in the patient pathway to target structured data entry interventions. Materials and methods: This mixed methods study was conducted in the largest pituitary centre in the UK. Purposive snowball sampling identified frontline stakeholders for process mapping to produce a patient pathway. The final patient pathway was subsequently validated against a real-world dataset of 50 patients who underwent surgery for pituitary adenoma. Events were categorized by frequency and mapped to the patient pathway to determine critical data points. Results: Eighteen stakeholders encompassing all members of the multidisciplinary team (MDT) were consulted for process mapping. The commonest events recorded were neurosurgical ward round entries (N = 212, 14.7%), pituitary clinical nurse specialist (CNS) ward round entries (N = 88, 6.12%) and pituitary MDT treatment decisions (N = 88, 6.12%) representing critical data points. Operation notes and neurosurgical ward round entries were present for every patient. 43/44 (97.7%) had a pre-operative pituitary MDT entry, pre-operative clinic letter, a post-operative clinic letter, an admission clerking entry, a discharge summary, and a post-operative histopathology pituitary multidisciplinary (MDT) team entries. Conclusion: This is the first study to produce a validated patient pathway of patients undergoing pituitary surgery, serving as a comparison to optimise this patient pathway. We have identified salient targets for structured data entry interventions, including mandatory datapoints seen in every admission and have also identified areas to improve documentation adherence, both of which support movement towards automation.

Indexed as

Pituitary NeoplasmsElectronic Health RecordsHumansReferral and Consultationdata collectionpatient pathwaypituitary adenomapituitary surgeryprocess mapping

Identifiers

PMID38283749
PMCPMC10811105
OpenAlexW4390815703

What OpenQuestion holds

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LicenceCC BY
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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.