Evidence map›Paper›PMID 38506921›Full record

ArticleJMIR research protocols2024

Using a Rapid Learning Health System for Stratified Care in Emerging Adult Mental Health Services: Protocol for the Implementation of Patient-Reported Outcome Measures.

Gina Dimitropoulos, David Lindenbach, Melissa Potestio, Tom Mogan, Amanda Richardson, Alida Anderson, Madison Heintz, Karen Moskovic, Jason Gondziola, Jessica Bradley and 5 more

Open access · goldAbstract read
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. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.5field-weighted citation impact, top 12% 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

3 citing papers in PubMed, 3 citations in OpenAlex.

  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

15 authors at 3 institutions in 2 countries.

Gina DimitropoulosMathison Centre for Mental Health & Education, University of Calgary, Calgary, AB, Canada.ORCID https://orcid.org/0000-0001-9487-0290
David LindenbachMathison Centre for Mental Health & Education, University of Calgary, Calgary, AB, Canada.ORCID https://orcid.org/0000-0002-9422-697X
Melissa PotestioAlberta Health Services, Edmonton, AB, Canada.ORCID https://orcid.org/0000-0002-0768-309X
Tom MoganAlberta Health Services, Edmonton, AB, Canada.ORCID https://orcid.org/0009-0008-8427-8558
Amanda RichardsonAlberta Health Services, Edmonton, AB, Canada.ORCID https://orcid.org/0009-0004-6936-6198
Alida AndersonMathison Centre for Mental Health & Education, University of Calgary, Calgary, AB, Canada.ORCID https://orcid.org/0009-0008-8814-1401
Madison HeintzMathison Centre for Mental Health & Education, University of Calgary, Calgary, AB, Canada.ORCID https://orcid.org/0009-0007-6268-8495
Karen MoskovicAlberta Health Services, Edmonton, AB, Canada.ORCID https://orcid.org/0009-0004-5269-1517
Jason GondziolaAlberta Health Services, Edmonton, AB, Canada.ORCID https://orcid.org/0009-0001-2661-7434
Jessica BradleyAlberta Health Services, Edmonton, AB, Canada.ORCID https://orcid.org/0009-0005-2795-3818
Haley M LaMonicaBrain and Mind Centre, The University of Sydney, Sydney, Australia.ORCID https://orcid.org/0000-0002-6563-5467
Frank IorfinoBrain and Mind Centre, The University of Sydney, Sydney, Australia.ORCID https://orcid.org/0000-0003-1109-0972
Ian HickieBrain and Mind Centre, The University of Sydney, Sydney, Australia.ORCID https://orcid.org/0000-0001-8832-9895
Scott B PattenMathison Centre for Mental Health & Education, University of Calgary, Calgary, AB, Canada.ORCID https://orcid.org/0000-0001-9871-4041
Paul D ArnoldMathison Centre for Mental Health & Education, University of Calgary, Calgary, AB, Canada.ORCID https://orcid.org/0000-0003-2496-4624
Alberta Health Services · CAUniversity of Calgary · CAThe University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMental illness among emerging adults is often difficult to ameliorate due to fluctuating symptoms and heterogeneity. Recently, innovative approaches have been developed to improve mental health care for emerging adults, including (1) implementing patient-reported outcome measures (PROMs) to assess illness severity and inform stratified care to assign emerging adults to a treatment modality commensurate with their level of impairment and (2) implementing a rapid learning health system in which data are continuously collected and analyzed to generate new insights, which are then translated to clinical practice, including collaboration among clients, health care providers, and researchers to co-design and coevaluate assessment and treatment strategies.

objectiveThe aim of the study is to determine the feasibility and acceptability of implementing a rapid learning health system to enable a measurement-based, stratified care treatment strategy for emerging adults.

methodsThis study takes place at a specialty clinic serving emerging adults (age 16-24 years) in Calgary, Canada, and involves extensive collaboration among researchers, providers, and youth. The study design includes six phases: (1) developing a transdiagnostic platform for PROMs, (2) designing an initial stratified care model, (3) combining the implementation of PROMs with stratified care, (4) evaluating outcomes and disseminating results, (5) modification of stratified care based on data derived from PROMs, and (6) spread and scale to new sites. Qualitative and quantitative feedback will be collected from health care providers and youth throughout the implementation process. These data will be analyzed at regular intervals and used to modify the way future services are delivered. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework is used to organize and evaluate implementation according to 3 key objectives: improving treatment selection, reducing average wait time and treatment duration, and increasing the value of services.

resultsThis project was funded through a program grant running from 2021 to 2026. Ethics approval for this study was received in February 2023. Presently, we have developed a system of PROMs and organized clinical services into strata of care. We will soon begin using PROMs to assign clients to a stratum of care and using feedback from youth and clinicians to understand how to improve experiences and outcomes.

conclusionsThis study has key implications for researchers and clinicians looking to understand how to customize emerging adult mental health services to improve the quality of care and satisfaction with care. This study has significant implications for mental health care systems as part of a movement toward value-based health care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51667.

Indexed as

acceptabilityadulte-mental healthemerging adultshealth systemimplementationimplementation sciencelearning health systemmeasurement-based caremental healthpatient-reported outcome measurespragmatic clinical trialsprotocol papersReach, Effectiveness, Adoption, Implementation, and MaintenanceRE-AIMstratified caretreatment

Identifiers

PMID38506921
PMCPMC10993112
OpenAlexW4391687326

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.