Evidence map›Paper›PMID 39657177›Full record

Trial reportJournal of medical Internet research2024

Postimplementation Evaluation in Assisted Living Facilities of an eHealth Medical Device Developed to Predict and Avoid Unplanned Hospitalizations: Pragmatic Trial.

Jacques-Henri Veyron, François Deparis, Marie Noel Al Zayat, Joël Belmin, Charlotte Havreng-Théry

Registry-linked trialAbstract readMulticenter StudyPragmatic Clinical Trial
In one paragraph

Trial report in Journal of medical Internet research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05221697 (Effect of an Electronic Alert Management System Using Caregivers' Observations and Machine Learning Algorithm to Reduce the Use of Emergency Department Visits and Unplanned Hospitalizations Among Older People), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

NCT05221697 naunknown statusnot on this map

Effect of an Electronic Alert Management System Using Caregivers' Observations and Machine Learning Algorithm to Reduce the Use of Emergency Department Visits and Unplanned Hospitalizations Among Older People

TypeinterventionalSponsorPresageRan2020 to 2024Enrolled800ConditionsEmergenciesArmsPRESAGE CARE
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
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

5 authors.

Jacques-Henri VeyronPresage, Paris, France.ORCID 0000-0002-3262-266X
François DeparisArpavie, Issy-les-Moulineaux, France.ORCID 0009-0009-5880-4638
Marie Noel Al ZayatPresage, Paris, France.ORCID 0009-0008-5929-1136
Joël BelminLaboratoire Informatique Médicale et Ingénierie des Connaissances en e-santé (UMRS 1142), Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, Paris, France.ORCID 0000-0003-1630-9582
Charlotte Havreng-ThéryPresage, Paris, France.ORCID 0000-0003-1247-5268

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe proportion of very old adults in the population is increasing, representing a significant challenge. Due to their vulnerability, there is a higher frequency of unplanned hospitalizations in this population, leading to adverse events. Digital tools based on artificial intelligence (AI) can help to identify early signs of vulnerability and unfavorable health events and can contribute to earlier and optimized management.

objectiveThis study aims to report the implementation in assisted living facilities of an innovative monitoring system (Presage Care) for predicting the short-term risk of emergency hospitalization. We describe its use and assess its performance.

methodsAn uncontrolled multicenter intervention study was conducted between March and August 2022 in 7 assisted living facilities in France that house very old and vulnerable adults. The monitoring system was set up to provide alerts in cases of a high risk of emergency hospitalization. Nurse assistants (NAs) at the assisted living facilities used a smartphone app to complete a questionnaire on the functional status of the patients, comprising electronic patient-reported outcome measures (ePROMs); these were analyzed in real time by a previously designed machine learning algorithm. This remote monitoring of patients using ePROMs allowed notification of a coordinating nurse or a coordinating NA who subsequently informed the patient's nurses or physician. The primary outcomes were the acceptability and feasibility of the monitoring system in the context and confirmation of the effectiveness and efficiency of AI in risk prevention and detection in practical, real-life scenarios. The secondary outcome was the hospitalization rate after alert-triggered interventions.

resultsIn this study, 118 of 194 (61%) eligible patients were included who had at least 1 follow-up visit. A total of 38 emergency hospitalizations were documented. The system generated 92 alerts for 47 of the 118 (40%) patients. Of these 92 alerts, 46 (50%) led to 46 health care interventions for 14 of the 118 (12%) patients and resulted in 4 hospitalizations. The other 46 of the 92 (50%) alerts did not trigger a health care intervention and resulted in 25 hospitalizations (P<.001). Almost all hospitalizations were associated with a lack of alert-triggered interventions (P<.001). System performance to predict hospitalization had a high specificity (96%) and negative predictive value (99.4%).

conclusionsThe Presage Care system has been implemented with success in assisted living facilities. It was well accepted by coordinating nurses and performed well in predicting emergency hospitalizations. However, its use by NAs was less than expected. Overall, the system performed well in terms of performance and clinical impact in this setting. Nevertheless, further work is needed to improve the moderate use rate by NAs.

trial registrationClinicalTrials.gov NCT05221697; https://clinicaltrials.gov/study/NCT05221697.

Indexed as

Assisted Living FacilitiesHospitalizationTelemedicineAgedAged, 80 and overFemaleFranceHumansMaleagingAIappartificial intelligenceassisted living facilitydigital technologyeHealthelectronic patient-reported outcome measureePROMFrancegerontologymachine learningolder peoplepragmatic trialpredictive toolquality of liferemote monitoring of patientssmartphonetelehealthtelemonitoringuncontrolled multicenter trialunplanned hospitalization

Identifiers

PMID39657177
PMCPMC11668978

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Registered trials

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.