Improved Rates of Successful Transfer of Care of Young Adults with Juvenile Idiopathic Arthritis with the Implementation of a Multi-Disciplinary Transition Clinic
Notice bibliographique
Résumé
Objectives This study aimed to evaluate the efficacy of the implementation of a comprehensive juvenile idiopathic arthritis (JIA) transition clinic in improving the rates of successful transfer from a pediatric rheumatology team to an adult rheumatologist.[1] Methods We conducted a retrospective systematic chart review of all patients with JIA who attended their final Montreal Children’s Hospital appointment between 1992 and 2005 and compared them with the cohort who had their final appointment between 2013 and 2021. We tracked these patients for 2 years after transferring to an adult rheumatologist. If the patient never made contact with the identified adult rheumatologist or was lost to follow-up at 2 years, then this patient was deemed an unsuccessful transfer. Within the post-intervention group, we compared characteristics of patients with successful and unsuccessful transfers of care and looked at the services they received in the transition program. Variables pertaining to sex, disease characteristics, disease severity, psychosocial factors and the number of allied health care appointments attended as part of the multi-disciplinary program were examined. Univariate analyses were performed to assess factors associated with the outcome of successful transfer of care. Results In the pre-intervention cohort, 100 patient charts were reviewed. This was compared with 152 charts from the post-intervention cohort. Following the introduction of a multidisciplinary transition clinic, our rate of successful transfer increased from 48% in the pre-intervention period to 94% in the post-intervention cohort (see Table 1). Variables related to disease characteristics did not predict successful transfer of care. However, patients in the post-intervention group who attended more than 2 supplemental allied health appointments were more likely to have a successful transfer of care OR 14.3 (CI 2.89-70.92). Table 1. Characteristics of patients referred for transition to adult care following implementation of a comprehensive multi-disciplinary JIA transition clinic (n=152) Conclusion In the pre-intervention cohort, the 52% rate of unsuccessful transfer from pediatric to adult care mirrored the rates seen in other pediatric chronic illnesses. The improvement that we have seen in this rate reflects a sustained effort to address the unique needs of this patient population. We cannot draw conclusions about the value of any individual service offered through our transition program due to small numbers in the study. However, the inclusion of multiple allied health services did seem to improve overall outcomes, supporting our approach of a patient-centered model of transition of care. [1.] Hazel E. Pediatric Rheumatology 2010;8:2.
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 | 0,004 | 0,029 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
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 ».