Evidence map›Paper›PMID 38386370›Full record

ArticleJMIR research protocols2024

A Virtual Hospital Model of Care for Low Back Pain, Back@Home: Protocol for a Hybrid Effectiveness-Implementation Type-I Study.

Alla Melman, Min Jiat Teng, Danielle M Coombs, Qiang Li, Laurent Billot, Thomas Lung, Eileen Rogan, Mona Marabani, Owen Hutchings, Chris G Maher and 2 more

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JMIR research protocols, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 31% 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

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Alla Melman *Sydney Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, Australia.ORCID 0000-0003-3726-1477
Min Jiat Teng *Sydney Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, Australia.ORCID 0000-0003-4948-0335
Danielle M CoombsSydney Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, Australia.ORCID 0000-0003-0005-7851
Qiang LiThe George Institute for Global Health, University of New South Wales, Sydney, Australia.ORCID 0000-0002-4384-8226
Laurent BillotThe George Institute for Global Health, University of New South Wales, Sydney, Australia.ORCID 0000-0002-4975-9793
Thomas LungThe George Institute for Global Health, University of New South Wales, Sydney, Australia.ORCID 0000-0001-9978-6311
Eileen RoganDepartment of Medicine, Canterbury Hospital, Sydney Local Health District, Sydney, Australia.ORCID 0009-0003-4059-4085
Mona MarabaniDepartment of Medicine, Canterbury Hospital, Sydney Local Health District, Sydney, Australia.ORCID 0000-0003-0867-3106
Owen HutchingsRPA Virtual Hospital, Sydney Local Health District, Sydney, Australia.ORCID 0000-0002-2793-0027
Chris G MaherSydney Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, Australia.ORCID 0000-0002-1628-7857
Gustavo C MachadoSydney Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, Australia.ORCID 0000-0002-8544-0448
The Back@Home Investigators
The University of Sydney · AUCanterbury Hospital · AUUNSW Sydney · AUSydney Local Health District · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLow back pain (LBP) was the fifth most common reason for an emergency department (ED) visit in 2020-2021 in Australia, with >145,000 presentations. A total of one-third of these patients were subsequently admitted to the hospital. The admitted patient care accounts for half of the total health care expenditure on LBP in Australia.

objectiveThe primary aim of the Back@Home study is to assess the effectiveness of a virtual hospital model of care to reduce the length of admission in people presenting to ED with musculoskeletal LBP. A secondary aim is to evaluate the acceptability and feasibility of the virtual hospital and our implementation strategy. We will also investigate rates of traditional hospital admission from the ED, representations and readmissions to the traditional hospital, demonstrate noninferiority of patient-reported outcomes, and assess cost-effectiveness of the new model.

methodsThis is a hybrid effectiveness-implementation type-I study. To evaluate effectiveness, we plan to conduct an interrupted time-series study at 3 metropolitan hospitals in Sydney, New South Wales, Australia. Eligible patients will include those aged 16 years or older with a primary diagnosis of musculoskeletal LBP presenting to the ED. The implementation strategy includes clinician education using multimedia resources, staff champions, and an "audit and feedback" process. The implementation of "Back@Home" will be evaluated over 12 months and compared to a 48-month preimplementation period using monthly time-series trends in the average length of hospital stay as the primary outcome. We will construct a plot of the observed and expected lines of trend based on the preimplementation period. Linear segmented regression will identify changes in the level and slope of fitted lines, indicating immediate effects of the intervention, as well as effects over time. The data will be fully anonymized, with informed consent collected for patient-reported outcomes.

resultsAs of December 6, 2023, a total of 108 patients have been cared for through Back@Home. A total of 6 patients have completed semistructured interviews regarding their experience of virtual hospital care for nonserious back pain. All outcomes will be evaluated at 6 months (August 2023) and 12 months post implementation (February 2024).

conclusionsThis study will serve to inform ongoing care delivery and implementation strategies of a novel model of care. If found to be effective, it may be adopted by other health districts, adapting the model to their unique local contexts. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/50146.

Indexed as

backback paincosteconomiceHealthhome carehospital-based home carehospital stayimplementationlength of staymobile phonemodel of caremusculoskeletalmusculoskeletal painpainreadmissionremote caretelehealthtelemedicinevirtual carevirtual hospital

Identifiers

PMID38386370
PMCPMC10921332
OpenAlexW4389689977

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.