Event Surrogate from Clinical Pathway Completion to Daily Meal for Availability Extension Using Standard Electronic Medical Records: a Retrospective Cohort Study.

This study aimed to improve generalizability of our previous study that analyzed clinical pathway (CP) completion. Although our previous study demonstrated that CP completion can reduce the length of hospital stay, it is possible for few medical organizations to extract the implementation of treatme...

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Published in:Journal of Medical Systems Vol. 45; no. 3; pp. 1 - 10
Main Authors: Furuhata, Hiroki, Araki, Kenji, Ogawa, Taisuke
Format: equations & formulas research tables/charts Journal Article
Published: Springer Nature Mar2021
Online Access:View this record in EBSCOhost
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      dt: Mar2021
      vid: 45
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10916-021-01714-x
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        atl: Event Surrogate from Clinical Pathway Completion to Daily Meal for Availability Extension Using Standard Electronic Medical Records: a Retrospective Cohort Study.
      aug:
        au:
          Furuhata, Hiroki
          Araki, Kenji
          Ogawa, Taisuke
        affil: Department of Hospital Institutional Research, University of Miyazaki Hospital, 5200 Kibara Kiyotake-cho, 8891692, Miyazaki, Japan
      sug:
        subj:
          Critical Path
          Meals
          Biological Markers
          Quality Improvement
          Human
          Electronic Health Records
          Retrospective Design
          Prospective Studies
          Academic Medical Centers
          Data Analysis, Statistical
          Patient Classification
          Descriptive Statistics
          Length of Stay
          International Classification of Diseases
          Adult
          Middle Age
          Aged
          Male
          Female
          Chi Square Test
          T-Tests
          Data Analysis Software
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: This study aimed to improve generalizability of our previous study that analyzed clinical pathway (CP) completion. Although our previous study demonstrated that CP completion can reduce the length of hospital stay, it is possible for few medical organizations to extract the implementation of treatment registered on CP from typical electronic medical records. Therefore, we have defined a prospective event for event substitution, called meal completion (MC), in which patients can take their meal daily. Data were collected from April 2013 to March 2018 from the electronic medical records of the University of Miyazaki Hospital. We used propensity score matching to extract records from 8033 patients. Patients were further divided into the MC and non-MC groups; 2577 patients in each group were available for data analysis. The numbers of patients with CP completion were 646 (28.1%) in the MC group and 411 (18.2%) in the non-MC group. The P value of the chi-square test was <0.001. According to this result, there was the causation from MC to increase in CP completion. Additionally, it was possible to consider the inclusion relationship in all treatments (universal set), treatments registered on CP (subset of all treatments), and meals (subset of treatments registered on CP). In conclusion, MC can substitute for CP completion because the demonstration is appropriate for the Prentice criterion, which is often used for the evaluation of a surrogate endpoint.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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