External validation of the detection of indicators and vulnerabilities for emergency room trips (DIVERT) scale: a retrospective cohort study
Abstract Background The Detection of Indicators and Vulnerabilities of Emergency Room Trips (DIVERT) scale was developed to classify and estimate the risk of emergency department (ED) use among home care clients. The objective of this study was to externally validate the DIVERT scale in a secondary...
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crspringernat:10.1186/s12877-020-01816-0 2023-05-15T18:44:11+02:00 External validation of the detection of indicators and vulnerabilities for emergency room trips (DIVERT) scale: a retrospective cohort study Mowbray, Fabrice I. Jones, Aaron Schumacher, Connie Hirdes, John Costa, Andrew P. 2020 http://dx.doi.org/10.1186/s12877-020-01816-0 https://link.springer.com/content/pdf/10.1186/s12877-020-01816-0.pdf https://link.springer.com/article/10.1186/s12877-020-01816-0/fulltext.html en eng Springer Science and Business Media LLC https://creativecommons.org/licenses/by/4.0 https://creativecommons.org/licenses/by/4.0 CC-BY BMC Geriatrics volume 20, issue 1 ISSN 1471-2318 Geriatrics and Gerontology journal-article 2020 crspringernat https://doi.org/10.1186/s12877-020-01816-0 2021-11-02T14:35:59Z Abstract Background The Detection of Indicators and Vulnerabilities of Emergency Room Trips (DIVERT) scale was developed to classify and estimate the risk of emergency department (ED) use among home care clients. The objective of this study was to externally validate the DIVERT scale in a secondary population of home care clients. Methods We conducted a retrospective cohort study, linking data from the Home Care Reporting System and the National Ambulatory Care Reporting System. Data were collected on older long-stay home care clients who received a RAI Home Care (RAI-HC) assessment. Data were collected for home care clients in the Canadian provinces of Ontario and Alberta, as well as in the cities of Winnipeg, Manitoba and Whitehorse, Yukon Territories between April 1, 2011 and September 30, 2014. The DIVERT scale was originally derived from the items of the RAI-HC through the use of recursive partitioning informed by a multinational clinical panel. This scale is currently implemented alongside the RAI-HC in provinces across Canada. The primary outcome of this study was ED visitation within 6 months of a RAI-HC assessment. Results The cohort contained 1,001,133 home care clients. The vast majority of cases received services in Ontario (88%), followed by Alberta (8%), Winnipeg (4%), and Whitehorse (< 1%). Across the four cohorts, the DIVERT scale demonstrated similar discriminative ability to the original validation work for all outcomes during the six-month follow-up: ED visitation (AUC = 0.617–0.647), two or more ED visits (AUC = 0.628–0.634) and hospital admission (AUC = 0.617–0.664). Conclusions The findings of this study support the external validity of the DIVERT scale. More specifically, the predictive accuracy of the DIVERT scale from the original work was similar to the accuracy demonstrated within a new cohort, created from different geographical regions and time periods. Article in Journal/Newspaper Whitehorse Yukon Springer Nature (via Crossref) Canada Yukon BMC Geriatrics 20 1 |
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Open Polar |
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Springer Nature (via Crossref) |
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crspringernat |
language |
English |
topic |
Geriatrics and Gerontology |
spellingShingle |
Geriatrics and Gerontology Mowbray, Fabrice I. Jones, Aaron Schumacher, Connie Hirdes, John Costa, Andrew P. External validation of the detection of indicators and vulnerabilities for emergency room trips (DIVERT) scale: a retrospective cohort study |
topic_facet |
Geriatrics and Gerontology |
description |
Abstract Background The Detection of Indicators and Vulnerabilities of Emergency Room Trips (DIVERT) scale was developed to classify and estimate the risk of emergency department (ED) use among home care clients. The objective of this study was to externally validate the DIVERT scale in a secondary population of home care clients. Methods We conducted a retrospective cohort study, linking data from the Home Care Reporting System and the National Ambulatory Care Reporting System. Data were collected on older long-stay home care clients who received a RAI Home Care (RAI-HC) assessment. Data were collected for home care clients in the Canadian provinces of Ontario and Alberta, as well as in the cities of Winnipeg, Manitoba and Whitehorse, Yukon Territories between April 1, 2011 and September 30, 2014. The DIVERT scale was originally derived from the items of the RAI-HC through the use of recursive partitioning informed by a multinational clinical panel. This scale is currently implemented alongside the RAI-HC in provinces across Canada. The primary outcome of this study was ED visitation within 6 months of a RAI-HC assessment. Results The cohort contained 1,001,133 home care clients. The vast majority of cases received services in Ontario (88%), followed by Alberta (8%), Winnipeg (4%), and Whitehorse (< 1%). Across the four cohorts, the DIVERT scale demonstrated similar discriminative ability to the original validation work for all outcomes during the six-month follow-up: ED visitation (AUC = 0.617–0.647), two or more ED visits (AUC = 0.628–0.634) and hospital admission (AUC = 0.617–0.664). Conclusions The findings of this study support the external validity of the DIVERT scale. More specifically, the predictive accuracy of the DIVERT scale from the original work was similar to the accuracy demonstrated within a new cohort, created from different geographical regions and time periods. |
format |
Article in Journal/Newspaper |
author |
Mowbray, Fabrice I. Jones, Aaron Schumacher, Connie Hirdes, John Costa, Andrew P. |
author_facet |
Mowbray, Fabrice I. Jones, Aaron Schumacher, Connie Hirdes, John Costa, Andrew P. |
author_sort |
Mowbray, Fabrice I. |
title |
External validation of the detection of indicators and vulnerabilities for emergency room trips (DIVERT) scale: a retrospective cohort study |
title_short |
External validation of the detection of indicators and vulnerabilities for emergency room trips (DIVERT) scale: a retrospective cohort study |
title_full |
External validation of the detection of indicators and vulnerabilities for emergency room trips (DIVERT) scale: a retrospective cohort study |
title_fullStr |
External validation of the detection of indicators and vulnerabilities for emergency room trips (DIVERT) scale: a retrospective cohort study |
title_full_unstemmed |
External validation of the detection of indicators and vulnerabilities for emergency room trips (DIVERT) scale: a retrospective cohort study |
title_sort |
external validation of the detection of indicators and vulnerabilities for emergency room trips (divert) scale: a retrospective cohort study |
publisher |
Springer Science and Business Media LLC |
publishDate |
2020 |
url |
http://dx.doi.org/10.1186/s12877-020-01816-0 https://link.springer.com/content/pdf/10.1186/s12877-020-01816-0.pdf https://link.springer.com/article/10.1186/s12877-020-01816-0/fulltext.html |
geographic |
Canada Yukon |
geographic_facet |
Canada Yukon |
genre |
Whitehorse Yukon |
genre_facet |
Whitehorse Yukon |
op_source |
BMC Geriatrics volume 20, issue 1 ISSN 1471-2318 |
op_rights |
https://creativecommons.org/licenses/by/4.0 https://creativecommons.org/licenses/by/4.0 |
op_rightsnorm |
CC-BY |
op_doi |
https://doi.org/10.1186/s12877-020-01816-0 |
container_title |
BMC Geriatrics |
container_volume |
20 |
container_issue |
1 |
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1766234771436863488 |