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External validation of a claims-based and clinical approach for predicting post-pulmonary embolism outcomes among United States veterans

Overview of attention for article published in Internal and Emergency Medicine, February 2017
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9 Mendeley
Title
External validation of a claims-based and clinical approach for predicting post-pulmonary embolism outcomes among United States veterans
Published in
Internal and Emergency Medicine, February 2017
DOI 10.1007/s11739-017-1625-9
Pubmed ID
Authors

Christine G. Kohn, Erin R. Weeda, Neela Kumar, Philip S. Wells, W. Frank Peacock, Gregory J. Fermann, Li Wang, Onur Baser, Jeff R. Schein, Concetta Crivera, Craig I. Coleman

Abstract

The In-hospital Mortality for PulmonAry embolism using Claims daTa (IMPACT) rule can accurately identify pulmonary embolism (PE) patients at low risk of early complications using claims data. We sought to externally validate the IMPACT and simplified Pulmonary Embolism Severity Index (sPESI) tools for predicting all-cause mortality and readmission. We used Veteran Health Administration data (10/1/2010-9/30/2015) to identify adults with ≥1 inpatient diagnosis code for acute PE, ≥12 months continuous medical and pharmacy benefits prior to the index PE, ≥90 days of post-event follow-up (unless death occurred) and ≥1 claim for an anticoagulant during the index PE stay. Prognostic accuracies of IMPACT and sPESI for 30- and 90-day all-cause mortality and 90-day readmission were estimated. Of 6,746 PE patients, 7.5 and 12.6% died at 30 and 90 days. Within 90 days, 20.1% were readmitted for any reason. Hospitalization for recurrent VTE and major bleeding occurred in 5.6 and 1.7% of patients. IMPACT classified 15.2% as low risk, while 28.4% were low risk per sPESI. Both tools displayed sensitivity >90% and negative predictive values (NPVs) >97% for 30-day mortality, but low specificity (range 16.2-30.0) and positive predictive values (PPVs) (range 8.7-9.5); with similar results observed for 90-day mortality. IMPACT's sensitivity for all-cause readmission was numerically higher than sPESI (88.2 vs. 79.0%), but both had comparable NPVs (85.1 vs. 84.2%). Similar trends were observed for VTE or major bleeding readmissions. IMPACT classified patients for post-PE outcomes with similar accuracy as sPESI. IMPACT appears useful for identifying PE patients at low risk for early mortality or readmission in claims-based studies.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 9 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Canada 1 11%
Unknown 8 89%

Demographic breakdown

Readers by professional status Count As %
Unspecified 3 33%
Other 2 22%
Student > Doctoral Student 2 22%
Student > Postgraduate 1 11%
Researcher 1 11%
Other 0 0%
Readers by discipline Count As %
Unspecified 4 44%
Medicine and Dentistry 3 33%
Economics, Econometrics and Finance 1 11%
Agricultural and Biological Sciences 1 11%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 May 2017.
All research outputs
#5,997,113
of 10,263,476 outputs
Outputs from Internal and Emergency Medicine
#168
of 330 outputs
Outputs of similar age
#147,794
of 264,566 outputs
Outputs of similar age from Internal and Emergency Medicine
#2
of 12 outputs
Altmetric has tracked 10,263,476 research outputs across all sources so far. This one is in the 25th percentile – i.e., 25% of other outputs scored the same or lower than it.
So far Altmetric has tracked 330 research outputs from this source. They receive a mean Attention Score of 4.2. This one is in the 36th percentile – i.e., 36% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 264,566 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 34th percentile – i.e., 34% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 12 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 75% of its contemporaries.