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73/100

✓ Peer-reviewed alzhub usefulness score 73 out of 100. Costs and economics

Topic: Health services, long-term care and technology

Plain-language summary

ACP billing codes from 6 months before to 6 months after admission for inpatient surgery. This study included 289,428 patients with ADRD undergoing surgery, of whom 21,754 (7.5%) had billed ACP within the 6 months before and after surgical admission. In a multivariable analysis, patients of white race, male sex, and residence in the Southern and Midwestern United States were at the highest risk of not receiving ACP. Of all patients who received ACP, 5960 (27.4%) did so before surgery while 12,658 (52.8%) received ACP after surgery. Timing of ACP after surgery was associated with an Elixhauser comorbidity index of 3 or higher (1.23, p = 0.045) and major postoperative complication or death (odds ratio 1.52, p < 0.0001). CONCLUSIONS AND RELEVANCE: Overall ACP billing code use is low among Medicare patients with ADRD undergoing surgery. Billed ACP appears to have a reactive pattern, occurring most commonly after surgery and in association with postoperative mortality and complications. Additional study is warranted to understand barriers to use.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Shah, S. K., Manful, A., Reich, A. J., Semco, R. S., Tjia, J., Ladin, K., et al. (2021). Advance care planning among Medicare beneficiaries with dementia undergoing surgery. Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.17226

Vancouver

Shah SK, Manful A, Reich AJ, Semco RS, Tjia J, Ladin K, et al. Advance care planning among Medicare beneficiaries with dementia undergoing surgery. Journal of the American Geriatrics Society. 2021. doi:10.1111/jgs.17226. PMID: 34014561.

BibTeX

@article{shah2021-34014561,
  author  = {Shah, Samir K and Manful, Adoma and Reich, Amanda J and Semco, Robert S and Tjia, Jennifer and Ladin, Keren and Weissman, Joel S},
  title   = {{Advance care planning among Medicare beneficiaries with dementia undergoing surgery}},
  journal = {Journal of the American Geriatrics Society},
  year    = {2021},
  doi     = {10.1111/jgs.17226},
  pmid    = {34014561},
  url     = {https://doi.org/10.1111/jgs.17226}
}

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.

How to read this study

Design: this is a follow-up (cohort) study. People are observed over time and not assigned to anything, so an association can reflect other differences between groups. Look at how long follow-up lasted, how many dropped out, and whether the authors adjusted for age, education and other health conditions.
Size: the record lists 289,428 participants. Ask whether that is enough for the question, and who they were.
Effect: the record reports “7.5%; 27.4%; 52.8%”. A statistically significant result can still be small in daily life.

What the evidence grade means here

This page is graded moderate. alzhub.org assigns the grade automatically from keywords in the abstract, not from reading the paper. Moderate means the abstract mentions a cohort, case-control or longitudinal design. It can add at most 5 of the 100 points in the study score, and it is a label about design, not a verdict on whether the findings are true.

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Key findings

ACP billing codes from 6 months before to 6 months after admission for inpatient surgery.
This study included 289,428 patients with ADRD undergoing surgery, of whom 21,754 (7.5%) had billed ACP within the 6 months before and after surgical admission.
In a multivariable analysis, patients of white race, male sex, and residence in the Southern and Midwestern United States were at the highest risk of not receiving ACP.
Of all patients who received ACP, 5960 (27.4%) did so before surgery while 12,658 (52.8%) received ACP after surgery.
Timing of ACP after surgery was associated with an Elixhauser comorbidity index of 3 or higher (1.23, p = 0.045) and major postoperative complication or death (odds ratio 1.52, p < 0.0001).

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Study details

Study designcohort study
Participants289,428
Effect size7.5%; 27.4%; 52.8%
Evidence strengthModerate

How this study scored 73/100

Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomized / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record, multicenter collaboration and free to read, so those were left out: it earned 41 of the 56 points we could judge it on, which is 73 out of 100.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society)
Journal's citation record	— / 4	No journal record from OpenAlex — left out of this score
Study design	7 / 12	A cohort study following people over time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	3 / 5	2021 — within 6 year(s) of the newest study here
Sample size	4 / 4	289,428 participants
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (participant count stated)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	— / 7	No citation count (not found in OpenAlex) — left out of this score
Citations per year	— / 5	No citation count or no year — left out of this score
Impact for its field and year	— / 6	No field-weighted citation impact (OpenAlex has none yet) — left out of this score
Cited by studies here	— / 6	Not yet checked against this library's citation graph — left out of this score
Still being cited	— / 4	No yearly citation counts — left out of this score
Senior author's track record	— / 4	Senior author's record not available — left out of this score
Institution's track record	— / 3	No institution listed in OpenAlex — left out of this score
Multicenter collaboration	— / 3	Institutions not listed — left out of this score
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 34014561)
Free to read	— / 2	Access not recorded — left out of this score
Points	41 / 56	Scored on 10 of 20 parts. We have no data for the rest, so they are left out: 41 of the 56 points we could judge it on is 73 out of 100.
Total	73 / 100	—

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