Editorial: Real world evidence, outcome research and healthcare management improvement through real world data (RWD)

Varela-Rodríguez, Carolina; Rosillo-Ramirez, Nicolás; Rubio-Valladolid, Gabriel; Ruiz-López, Pedro

doi:10.3389/fpubh.2022.1064580

Cited by 3 publications

(5 citation statements)

References 3 publications

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“…As mentioned before, overcrowding in EDs is an international problem 1 , 6 , and that regardless the massive quantity of works aimed to operational research there is still a lot of work to do to solve this problem 21 , 22 , especially in the current discussion on real-world evidence and healthcare data 19 , 26 , 75 . In the current discussion regarding data-driven healthcare in international settings, our pipeline could be interesting to implement for participatory approaches and to facilitate discussions about the problem from the perspectives of different healthcare policies.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, the use of real-world data in clinical practice to inform clinical decisions and systems operations has attracted significant interest 18 – 20 . Healthcare production data and Electronic Health Records (EHRs) present an opportunity to comprehensively analyse ED overcrowding and enhance healthcare system operations and management 19 – 21 .…”

Section: Introductionmentioning

confidence: 99%

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Diagnosing an overcrowded emergency department from its Electronic Health Records

Marzano,

Darwich,

Jayanth

et al. 2024

Sci Rep

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Emergency department overcrowding is a complex problem that persists globally. Data of visits constitute an opportunity to understand its dynamics. However, the gap between the collected information and the real-life clinical processes, and the lack of a whole-system perspective, still constitute a relevant limitation. An analytical pipeline was developed to analyse one-year of production data following the patients that came from the ED (n = 49,938) at Uppsala University Hospital (Uppsala, Sweden) by involving clinical experts in all the steps of the analysis. The key internal issues to the ED were the high volume of generic or non-specific diagnoses from non-urgent visits, and the delayed decision regarding hospital admission caused by several imaging assessments and lack of hospital beds. Furthermore, the external pressure of high frequent re-visits of geriatric, psychiatric, and patients with unspecified diagnoses dramatically contributed to the overcrowding. Our work demonstrates that through analysis of production data of the ED patient flow and participation of clinical experts in the pipeline, it was possible to identify systemic issues and directions for solutions. A critical factor was to take a whole systems perspective, as it opened the scope to the boundary effects of inflow and outflow in the whole healthcare system.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnosing an overcrowded emergency department from its Electronic Health Records

Marzano,

Darwich,

Jayanth

et al. 2024

Sci Rep

View full text Add to dashboard Cite

show abstract

“…As mentioned before, overcrowding in EDs is an international problem 1,6 , and that regardless the massive quantity of works aimed to operational research there is still a lot of work to do to solve this problem 21,22 , especially in the current discussion on real-world evidence and healthcare data 19,26,75 . In the current discussion regarding data-driven healthcare in international settings, our pipeline could be interesting to implement for participatory approaches and to facilitate discussions about the problem from the perspectives of different healthcare policies.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, the use of real-world data in clinical practice to inform clinical decisions and systems operations has attracted signi cant interest [18][19][20] . Healthcare production data and Electronic Health Records (EHRs) present an opportunity to comprehensively analyse ED overcrowding and enhance healthcare system operations and management [19][20][21] .…”

Section: Introductionmentioning

confidence: 99%

How to diagnose an overcrowded emergency department from its EHRs? Enhancing opportunities and challenges of real-world data from a whole-system perspective

Marzano,

Darwich,

Jayanth

et al. 2023

Preprint

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Emergency department overcrowding is a complex problem that persists globally. Data of visits constitute an opportunity to understand it. However, the gap between the collected information and the real-life clinical processes, and the lack of a whole-system perspective, still constitutes a relevant limitation. An analytical pipeline was developed to analyse one-year of production data following the patients that came from the ED (n = 49,938) at Uppsala University Hospital (Uppsala, Sweden) by involving clinical experts in all the steps of the analysis. The key internal issues to the ED were the high volume of generic or non-specific diagnoses from non-urgent visits, and the delayed decision regarding hospital admission caused by several imaging assessments and lack of hospital beds. Furthermore, the external pressure of high frequent re-visits of geriatric, psychiatric, and patients with unspecified diagnoses dramatically contributed to the overcrowding. Our work demonstrates that through analysis of production data of the ED patient flow and participation of clinical experts in the pipeline, it was possible to identify systemic issues and directions for solutions. A critical factor was to take a whole systems perspective, as it opened the scope to the boundary effects of inflow and outflow in the whole healthcare system.

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“…This process was designed to ensure the highest level of data accuracy. Patient demographics, clinical information about the disease, and postoperative complications were captured and recorded in an electronic data management platform [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

Shortness of breath on the day of discharge: an early alert for post-discharge complications in patients undergoing lung cancer surgery

Kang,

Lei,

Zhang

et al. 2024

J Cardiothorac Surg

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Purpose Symptom assessment based on patient-reported outcome (PRO) can correlate with disease severity, making it a potential tool for threshold alerts of postoperative complications. This study aimed to determine whether shortness of breath (SOB) scores on the day of discharge could predict the development of post-discharge complications in patients who underwent lung cancer surgery. Methods Patients were from a study of a dynamic perioperative rehabilitation cohort of lung cancer patients focusing on patient-reported outcomes. Patients were assessed using the Perioperative Symptom Assessment Scale for Lung surgery (PSA-Lung). Logistic regression model was used to examine the potential association between SOB on the day of discharge and complications within 3 months after discharge. The post-discharge complications were taken as the anchor variable to determine the optimal cutpoint for SOB on the day of discharge. Results Complications within 3 months post-discharge occurred in 71 (10.84%) of 655 patients. Logistic regression analysis revealed that being female (OR 1.764, 95% CI 1.006–3.092, P < 0.05) and having two chest tubes (OR 2.026, 95% CI 1.107–3.710, P < 0.05) were significantly associated with post-discharge complications. Additionally, the SOB score on the day of discharge (OR 1.125, 95% CI 1.012–1.250, P < 0.05) was a significant predictor. The optimal SOB cutpoint was 5 (on a scale of 0–10). Patients with an SOB score ≥ 5 at discharge experienced a lower quality of life 1 month later compared to those with SOB score<5 at discharge (73 [50–86] vs. 81 [65–91], P < 0.05). Conclusion SOB on the day of discharge may serve as an early warning sign for the timely detection of 3 month post-discharge complications.

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Editorial: Real world evidence, outcome research and healthcare management improvement through real world data (RWD)

Cited by 3 publications

References 3 publications

Diagnosing an overcrowded emergency department from its Electronic Health Records

Diagnosing an overcrowded emergency department from its Electronic Health Records

How to diagnose an overcrowded emergency department from its EHRs? Enhancing opportunities and challenges of real-world data from a whole-system perspective

Shortness of breath on the day of discharge: an early alert for post-discharge complications in patients undergoing lung cancer surgery

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