{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T23:17:52Z","timestamp":1775690272448,"version":"3.50.1"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,3,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Identification of stroke patients at increased risk of emergency department (ED) visits or hospital admissions allows implementation of mitigation strategies. We evaluated the ability of the Patient\u2010Reported Outcomes Information Measurement System (PROMIS) patient\u2010reported outcomes (PROs) collected as part of routine care to predict 1\u2010year emergency department (ED) visits and admissions when added to other readily available clinical variables.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">This was a cohort study of 1696 patients with ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, or transient ischemic attack seen in a cerebrovascular clinic from February 17, 2015, to June 11, 2018, who completed the following PROs at the visit: Patient Health Questionnaire\u20109, Quality of Life in Neurological Disorders cognitive function, PROMIS Global Health, sleep disturbance, fatigue, anxiety, social role satisfaction, physical function, and pain interference. A series of logistic regression models was constructed to determine the ability of models that include PRO scores to predict 1\u2010year ED visits and all\u2010cause and unplanned admissions. In the 1 year following the PRO encounter date, 1046 ED visits occurred in 548 patients; 751 admissions occurred in 453 patients. All PROs were significantly associated with future ED visits and admissions except PROMIS sleep. Models predicting unplanned admissions had highest optimism\u2010corrected area under the curve (range, 0.684\u20130.724), followed by ED visits (range, 0.674\u20130.691) and then all\u2010cause admissions (range, 0.628\u20130.671). PROs measuring domains of mental health had stronger associations with ED visits; PROs measuring domains of physical health had stronger associations with admissions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">PROMIS scales improve the ability to predict ED visits and admissions in patients with stroke. The differences in model performance and the most influential PROs in the prediction models suggest differences in factors influencing future hospital admissions and ED visits.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.018794","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T10:09:03Z","timestamp":1614938943000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Patient\u2010Reported Outcomes Predict Future Emergency Department Visits and Hospital Admissions in Patients With Stroke"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9006-7780","authenticated-orcid":false,"given":"Irene L.","family":"Katzan","sequence":"first","affiliation":[{"name":"Neurological Institute Center for Outcomes Research &amp; Evaluation Cleveland Clinic Cleveland OH"},{"name":"Cerebrovascular Center Cleveland Clinic Cleveland OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Thompson","sequence":"additional","affiliation":[{"name":"Neurological Institute Center for Outcomes Research &amp; Evaluation Cleveland Clinic Cleveland OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Schuster","sequence":"additional","affiliation":[{"name":"Neurological Institute Center for Outcomes Research &amp; Evaluation Cleveland Clinic Cleveland OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dolora","family":"Wisco","sequence":"additional","affiliation":[{"name":"Cerebrovascular Center Cleveland Clinic Cleveland OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brittany","family":"Lapin","sequence":"additional","affiliation":[{"name":"Neurological Institute Center for Outcomes Research &amp; Evaluation Cleveland Clinic Cleveland OH"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.007429"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.106.481465"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcma.2013.08.003"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.7863"},{"issue":"4","key":"e_1_3_1_6_2","first-page":"CD002990","article-title":"Self\u2010management education for patients with chronic obstructive pulmonary disease","author":"Effing T","year":"2007","unstructured":"Effing T, Monninkhof EM, van der Valk PD, van der Palen J, van Herwaarden CL, Partidge MR, Walters EH, Zielhuis GA. Self\u2010management education for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2007:4:CD002990.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_1_7_2","unstructured":"Deeny S Gardner T Al\u2010Zaidy S Barker T Steventon A. Briefing: reducing hospital admissions by improving continuity of care in general practice. London UK: The Health Foundation; 2017. Available at: https:\/\/www.health.org.uk\/sites\/default\/files\/ReducingAdmissionsGPContinuity.pdf. Accessed December 23 2020."},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12218"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.2217\/cpr.14.66"},{"key":"e_1_3_1_10_2","unstructured":"Agency for Clinical Innovation . Decision support tool: summary of patient identification and selection tools. NSW Government Australia. 2020. www.aci.health.nsw.gov.au\/resources\/chronic\u2010care\/aci\/risk\u2010stratification\u2010program."},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.1362"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.118.005320"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsmc.2015.10.009"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijs.12356"},{"key":"e_1_3_1_15_2","unstructured":"NEJM Catalyst . Patient Engagement Buzz Survey: PROMs Use Is Growing but Implementation Takes Effort. Massachusetts Medical Society Publisher. October 3 2019. Available at: catalyst.nejm.org\/doi\/full\/10.1056\/CAT.19.0704. NEJM Catalyst. 2019. 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