A180: A Population Management Tool for Proactive Care of Juvenile Idiopathic Arthritis in the Pediatric Rheumatology Care and Outcomes Improvement Network
Notice bibliographique
Résumé
Background/Purpose: The Pediatric Rheumatology Care and Outcomes Improvement Network (PR‐COIN) is a multi‐center, quality‐improvement‐focused learning network with a mission of improving outcomes for children and adolescents with juvenile idiopathic arthritis (JIA). PR‐COIN has developed a population management tool which facilitates pro‐active, coordinated health care communications and interventions that can be used in managing JIA patient populations. Methods: The population management tool was developed with information technology expertise to link seamlessly to the PR‐COIN longitudinal registry. Within the population management tool, on demand reports can be generated using participating site or aggregate, network level data according to demographics, clinical features, disease activity levels, patient reported outcomes (functional ability/CHAQ score, arthritis related pain), medication use, and quality indicators. Drill down capability enables identification of patients. Results: Currently, data from 8 sites, 1161 patients, and 5334 clinical encounters are included in the population management tool (Table ). Individual site usage of the population management tool is variable ranging from infrequent use to regular use at monthly population management meetings. The PR‐COIN network is currently developing strategies to promote consistent usage of the tool at sites. Clinicians routinely using information provided through this tool report satisfaction with its functionality and ease of use; furthermore they report enhanced ability to proactively identify and address specific patient needs prior to and during clinic visits, optimizing care. Aggregate patient data report from PR‐COIN population management tool Characteristic N = 1146 Age (years) < 2 4 (0.3%) 2–4 84 (7.6%) 5–7 148 (12.9%) 8–12 324 (28.3%) > 12 583 (50.9%) JIA subtype Oligoarticular persistent 236 (20.6%) Oligoarticular extended 132 (11.5%) Polyarticular, RF negative 396 (34.5%) Polyarticular, RF positive 99 (8.6%) Enthesitis related arthritis 63 (5.5%) Systemic 75 (6.5%) Undifferentiated 25 (2.2%) Disease status Clinically inactive disease on medications 264 (35.9%) Active uveitis 71 (6.2%) Prior history of uveitis, currently inactive 100 (8.7%) Physician global assessment (PGA) = 0–3 991 (86.4%) Optimal physical function 507 (57.1%) Pain score = 0 482 (42%) Other measures Compliant with uveitis screening 351 (30.6%) On biologic medication 418 (36.4%) Per Wallace criteria; PGA scale 0–10 CHAQ = 0; per Hellinghaus guidelines Conclusion: The population management tool allows real‐time feedback to sites regarding overall JIA population and individual patient status. Customized, “on demand” population measurement and quality improvement reports generated by the network and participating sites and can be used to identify gaps in patient care and at‐risk subpopulations that may benefit from more intensive or between‐visit care. Current efforts include developing a care stratification scores that can assist in identifying at risk JIA subpopulations and provision of individual patient reports that can be used to assist in pre‐visit planning. Future goals include providing feedback to individual patients about their disease status compared to local and network aggregate data, and customized educational and interventional tools that can be provided to JIA patients and families. Thus, the PR‐COIN JIA population management tool can be leveraged to improve JIA network and site performance and individual patient care.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,013 | 0,053 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,007 | 0,004 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,002 | 0,003 |
| Science ouverte | 0,001 | 0,004 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,018 | 0,003 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».