Evidence map›Paper›PMID 40440691›Full record

ArticleJMIR research protocols2025

Validating a Patient-Reported Outcome Measure to Improve Emergency Department Asthma Care: Protocol for an Observational Study.

Michelle P Lin, Lauren Gordon, Lynne D Richardson

Registry-linked trialAbstract read
In one paragraph

Article in JMIR research protocols, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04349020 (Patient Reported Outcomes for Acute Asthma Care Treatment), which is not on this map. Not yet cited in PubMed.

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0citing papers in PubMed
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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.

NCT04349020 unknown statusnot on this map

Patient Reported Outcomes for Acute Asthma Care Treatment

TypeobservationalSponsorStanford UniversityRan2019 to 2024Enrolled300ConditionsAsthma
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

3 authors.

Michelle P LinDepartment of Emergency Medicine, Stanford University, Palo Alto, CA, United States.ORCID 0000-0001-6045-7342
Lauren GordonDepartment of Emergency Medicine, Stanford University, Palo Alto, CA, United States.ORCID 0000-0002-0025-2510
Lynne D RichardsonDepartment of Emergency Medicine, Stanford University, Palo Alto, CA, United States.ORCID 0000-0002-5425-1601

Funding

PROAACT- Admin SupplementK23HL143042 · NHLBI · STANFORD UNIVERSITY · PI LIN, MICHELLE P · 2019 to 2023
$1.0M
NHLBI NIH HHS K23 HL143042
6 · The paper itself

Abstract

backgroundAsthma affects 1 in every 12 persons in the United States, resulting in 1.9 million emergency department (ED) visits annually. However, the lack of patient-reported outcome measures (PROMs) validated for use in the ED limits the evaluation of interventions to improve ED asthma care.

objectiveTo address this knowledge gap, this study protocol will (1) develop and test the validity and reliability of the Patient Reported Outcomes for Acute Asthma Care and Treatment instrument (PROAACT), (2) test whether receiving more guideline-concordant ED care is associated with improved PROAACT responses, and (3) evaluate the association between PROAACT score and subsequent ED revisits and hospitalizations.

methodsThis is a prospective cohort study of adult patients visiting the ED for acute asthma exacerbation across 3 EDs at an urban, tertiary care health system. Eligible patients are 18 years or older, have a prior diagnosis of asthma (self-reported or documented in the electronic health record), are English-speaking, and experiencing an ED visit for asthma exacerbation as determined by the treating clinician. Enrolled participants complete an initial PROM survey during their ED visit assessing their symptoms in the preceding 7 days, then complete a follow-up survey 7 days after ED discharge assessing changes in the symptoms in the subsequent 7 days. To test whether guideline-concordant care is associated with improved PROAACT scores, we will conduct a retrospective chart review of medications ordered during the ED visit, and then compare guideline adherence to changes in PROAACT scores. To test whether improved PROAACT scores are associated with fewer return ED visits and hospitalizations, we will extract all-cause ED visits and hospitalizations within 30 days from a regional health information exchange, and then compare usage to changes in PROAACT scores. We will use item response theory to develop scale responses based on summed item responses, which will allow us to test associations with clinical outcomes, including adherence to guideline-recommended care and return ED visits and hospitalizations.

resultsRecruitment is ongoing and has experienced numerous challenges related to the COVID-19 pandemic. To date, we have enrolled over 250 participants and have completed over 200 follow-ups. Recruitment is expected to conclude in spring 2025.

conclusionsOur study is intended to validate the use of PROMs during ED visits for acute asthma exacerbation among adult patients. Completion of the proposed aims will result in one of the first PROMs intended for use among adult ED patients and support the feasibility of collecting PROMs in the ED setting.

trial registrationClinical Trials.gov NCT04349020; https://clinicaltrials.gov/study/NCT04349020. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/67195.

Indexed as

AsthmaEmergency Service, HospitalPatient Reported Outcome MeasuresAdultFemaleHospitalizationHumansMaleMiddle AgedObservational Studies as TopicProspective StudiesReproducibility of Resultsasthmaemergency carepatient-reported outcomes

Identifiers

PMID40440691
PMCPMC12163351

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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.