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Changing outpatient referral patterns in a small pediatric nephrology practice

Overview of attention for article published in BMC Pediatrics, June 2018
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2 tweeters
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17 Mendeley
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Title
Changing outpatient referral patterns in a small pediatric nephrology practice
Published in
BMC Pediatrics, June 2018
DOI 10.1186/s12887-018-1164-1
Pubmed ID
Authors

Coral Hanevold, Susan Halbach, Jin Mou, Karyn Yonekawa

Abstract

We have noted a large number of referrals for abnormal kidney imaging and laboratory tests and postulated that such referrals have increased significantly over time. Understanding changes in referral patterns is helpful in tailoring education and communication between specialists and primary providers. We performed a retrospective chart review of new patient referrals to Mary Bridge Children's Nephrology clinic for early (2002 to 2004) and late (2011 to 2013) cohorts. The overall and individual frequencies of referrals for various indications were compared. The overall number of new visits was similar for early (511) and late (509) cohorts. The frequency of referrals for solitary kidneys and multi-cystic dysplastic kidneys, microalbuminuria and abnormal laboratory results increased significantly (Odds Ratio (OR) and 95% Confidence Interval of OR: 1.920 [1.079, 3.390], 2.862 [1.023, 8.006], 2.006 [1.083, 3.716], respectively) over the time interval while the proportion of referrals for urinary tract infections (UTIs) and vesicoureteral reflux (VUR) decreased by half (OR: 0.472, 95% CI: 0.288, 0.633). Similarly, referrals for urinary tract dilation and hydronephrosis occurred significantly less often (8% versus 6%, OR: 0.737, 95% CI: 0.452, 1.204) with similar changes in referrals for voiding issues (OR: 0.281, 95% CI: 0.137, 0.575). However, these changes were not statistically significant. Frequencies for other indications showed little variation. Changes in indications for referral likely reflect evolution of practice in management of UTIs and VUR and increased use of imaging and laboratory testing by pediatric providers. These findings have relevance for ongoing education of pediatricians and support the need for collaboration between primary providers and nephrologists to assure the judicious use of resources.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters 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 17 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 17 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 3 18%
Student > Master 3 18%
Researcher 2 12%
Professor > Associate Professor 2 12%
Student > Doctoral Student 1 6%
Other 2 12%
Unknown 4 24%
Readers by discipline Count As %
Medicine and Dentistry 8 47%
Nursing and Health Professions 2 12%
Social Sciences 1 6%
Unknown 6 35%

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 21 June 2018.
All research outputs
#8,223,306
of 13,116,247 outputs
Outputs from BMC Pediatrics
#1,089
of 1,594 outputs
Outputs of similar age
#159,568
of 268,174 outputs
Outputs of similar age from BMC Pediatrics
#1
of 1 outputs
Altmetric has tracked 13,116,247 research outputs across all sources so far. This one is in the 23rd percentile – i.e., 23% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,594 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.9. This one is in the 23rd percentile – i.e., 23% 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 268,174 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 31st percentile – i.e., 31% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them