The retrospective chart review: important methodological considerations

Vassar, Matt; Holzmann, Matthew

doi:10.3352/jeehp.2013.10.12

Cited by 411 publications

(310 citation statements)

References 18 publications

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“…Our limitations include the retrospective collection of data, which may have some negative impact on the precision of the results, although several authors and consensus groups defend that personal health information can be collected with reasonable precision if specific and pre-defined questions are employed [25,26]. We have carefully respected the ten main recommendations published by Matt et al [27] to ensure a good collection of data in retrospective studies.…”

Section: Discussionmentioning

confidence: 99%

The burden of osteoporotic hip fractures in Portugal: costs, health related quality of life and mortality

2015

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Summary The study rationale was to provide a detailed overview of the costs, quality of life and mortality of hip fractures in Portugal. Mean individual fracture-related costs were estimated at €13, 434 [12,290; 14,576] for the first year and €5985 [4982; 7045] for the second year following the fracture. Introduction Osteoporotic fractures represent a remarkable burden to health care systems and societies worldwide, which will tend to increase as life expectancy expands and lifestyle changes favour osteoporosis. The cost-effectiveness evaluation of intervention strategies demands accurate data on the epidemiological and economical reality to be addressed. Methods Information was collected retrospectively on consumption of resources and changes in quality of life attributable to fracture as well as mortality, regarding 186 patients randomly selected to represent the distribution of hip fractures in the Portuguese population, in terms of gender, age and geographical provenience. Data were cross-tabulated with socio-demographic variables and individual resource consumption to estimate the burden of disease. A societal perspective was adopted, including direct and indirect costs.Multivariate analyses were carried out to assess the main determinants of health-related quality of life (HrQoL). Results Mean individual fracture-related costs were estimated at €13, 434 [12,290; 14,576] for the first year and €5985 [4982; 7045] for the second year following the fracture. In 2011 the economic burden attributable to osteoporotic hip fractures in Portugal could be estimated at €216 million. Mean reduction in HrQoL 12 months after fracture was estimated at 0.34. Regression analysis showed that age was associated with a higher loss of HrQoL, whereas education had the opposing effect. We observed 12 % excess mortality in the first year after hip fracture, when compared to the gender and age-matched general population. Conclusions Results of this study indicate that osteoporotic hip fractures are, also in Portugal, despite its low incidence of fractures and cost per event, associated with a high societal burden, in terms of costs, loss in HrQoL and mortality. These data provide valuable input to the design and selection of fracture prevention strategies.

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Section: Discussionmentioning

confidence: 99%

The burden of osteoporotic hip fractures in Portugal: costs, health related quality of life and mortality

2015

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“…First, patients were identified from an existing MRI database making our study subject to limitations inherent to retrospective investigations (20). Despite this, we maintained a systematic and strict approach to determine inclusion eligibility.…”

Section: Limitationsmentioning

confidence: 99%

Cine-CMR partial voxel segmentation demonstrates increased aortic stiffness among patients with Marfan syndrome

Singh

Almarzooq

Codell³

et al. 2017

J. Thorac. Dis.

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Background: Standard cine-cardiac magnetic resonance (CMR) imaging is commonly used to evaluate cardiac structure, geometry and function. Prior studies have shown that automated segmentation via partial voxel interpolation (PVI) accurately quantifies phantom-based cardiac chamber volumes and necropsy left ventricular myocardial mass. Despite this, the applicability and usefulness of PVI in the determination of physiologic parameters of the aorta such as aortic stiffness has yet to be investigated. Methods: Routine CMR was conducted with a 1.5T (GE) scanner with pulse sequences similar to that of standard CMR (parameters: TR 3.4 msec, TE 1.14 msec, flip angle 60°, temporal resolution ~30-40 msec). Views were obtained in standard cardiac-oriented longitudinal or axial views (2, 3 and 4 chambers). Within non-dilated regions of the descending thoracic aorta, aortic area was quantified via a novel PVI automated process (LV-METRIC), which discerns relative amounts of blood pool in each voxel. Aortic stiffness, as calculated from brachial artery pulse pressure and aortic area at maximal and minimal dimensions, was evaluated in 60 total segments (one segment per patient). All segments were in the descending aorta and were not aneurysmal. Results: Sixty patients in total were studied, including 50 that had genetically-related aortic disorder [35 bicuspid aortic valve (BAV), 15 Marfan syndrome (MFS)]. Ten normal controls without aortic disease were included for comparison purposes. All patients (n=60) had evaluable CMR images for assessment of the descending aorta with use of automated segmentation. Patients with BAV and MFS were similar to controls in age, systolic blood pressure, brachial artery pulse pressure, smoking status or hypercholesterolemia (all P=NS). There were more women (P<0.001), lower body mass index (P=0.008), and greater height (P<0.001) in the MFS cohort compared to BAV and controls. Descending aortic area in either systole (maximal) or diastole (minimal) was similar among all three cohorts. However, change in aortic area (ΔArea) throughout the cardiac cycle was substantially lower in MFS than control subjects (P<0.001). In contrast, change in aortic area throughout the cardiac cycle was not significantly different between BAV vs. controls (P=0.62). Aortic stiffness was increased among MFS patients versus control subjects (P=0.014). When comparing MFS to BAV subjects, a comparable trend was observed (P=0.09). No statistical difference was evident in aortic stiffness in patients with BAV versus control subjects (P=0.29). Conclusions: The application of PVI to standard CMR imaging can assess abnormal descending aorta functional indices in normal caliber segments in MFS subjects. Future prospective studies with larger subject populations are warranted to further determine the overall utility of automated aortic segmentation as a possible early biomarker of aortic dysfunction before overt dilatation.

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“…Following best practices from Vassar & Holzmann (2013), the PI and research associate of the chart review study drew up a manual for data extraction from the screening form and from the electronic records, in consultation with a SBHC clinic manager from the same FQHC as Clinic A. Clinic staff were used to extract data from the electronic records currently used by the FQHC.…”

Section: Methodsmentioning

confidence: 99%

“…Missing data from screened youth was primarily a result of blanks on the screening forms, which may have been a function of language barriers for Guatemalan youth, a lack of understanding of the questions, and inconsistencies or skipped questions on the part of screeners, particularly if they noted any reluctance by youth. The analyzed sample (N= 56) was small relative to the number of variables, so inferential statistics were not possible (Vassar & Holzmann, 2013). Future chart reviews should narrow the number of questions asked in order to increase power of the sample and also in order to facilitate a more extensive chart review.…”

Section: Study Limitationsmentioning

confidence: 99%

Addressing the health and mental health needs of unaccompanied immigrant youth through an innovative school-based health center model: Successes and challenges

Schapiro

Gutierrez

Blackshaw

et al. 2018

Children and Youth Services Review

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The retrospective chart review: important methodological considerations

Cited by 411 publications

References 18 publications

The burden of osteoporotic hip fractures in Portugal: costs, health related quality of life and mortality

The burden of osteoporotic hip fractures in Portugal: costs, health related quality of life and mortality

Cine-CMR partial voxel segmentation demonstrates increased aortic stiffness among patients with Marfan syndrome

Addressing the health and mental health needs of unaccompanied immigrant youth through an innovative school-based health center model: Successes and challenges

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