Developing and Evaluating Data Infrastructure and Implementation Tools to Support Cardiometabolic Disease Indicator Data Collection

Abstract

Background Assessment of aerobic exercise (AE) and lipid profiles among individuals with spinal cord injury or disease (SCI/D) is critical for cardiometabolic disease (CMD) risk estimation. Objectives To utilize an artificial intelligence (AI) tool for extracting indicator data and education tools to enable routine CMD indicator data collection in inpatient/outpatient settings, and to describe and evaluate the recall of AE levels and lipid profile assessment completion rates across care settings among adults with subacute and chronic SCI/D. Methods A cross-sectional convenience sample of patients affiliated with University Health Network's SCI/D rehabilitation program and outpatients affiliated with SCI Ontario participated. The SCI-HIGH CMD intermediary outcome (IO) and final outcome (FO) indicator surveys were administered, using an AI tool to extract responses. Practice gaps were prospectively identified, and implementation tools were created to address gaps. Univariate and bivariate descriptive analyses were used. Results The AI tool had <2% error rate for data extraction. Adults with SCI/D (n = 251; 124 IO, mean age 61; 127 FO, mean age 55; p = .004) completed the surveys. Fourteen percent of inpatients versus 48% of outpatients reported being taught AE. Fifteen percent of inpatients and 51% of outpatients recalled a lipid assessment (p < .01). Algorithms and education tools were developed to address identified knowledge gaps in patient AE and lipid assessments. Conclusion Compelling CMD health service gaps warrant immediate attention to achieve AE and lipid assessment guideline adherence. AI indicator extraction paired with implementation tools may facilitate indicator deployment and modify CMD risk.