{"doi":"10.1002/acr.25134","title":"Improving Outcomes of Pediatric Lupus Care Delivery With Provider Goal‐Setting Activities and Multidisciplinary Care Models","abstract":"OBJECTIVE: The present study was undertaken to evaluate high-quality care delivery in the context of provider goal-setting activities and a multidisciplinary care model using an electronic health record (EHR)-enabled pediatric lupus registry. We then determined associations between care quality and prednisone use among youth with systemic lupus erythematosus (SLE). METHODS: We implemented standardized EHR documentation tools to autopopulate a SLE registry. We compared pediatric Lupus Care Index (pLCI) performance (range 0.0-1.0; 1.0 representing perfect metric adherence) and timely follow-up 1) before versus during provider goal-setting activities and population management, and 2) in a multidisciplinary lupus nephritis versus rheumatology clinic. We estimated associations between pLCI and subsequent prednisone use adjusted for time, current medication, disease activity, clinical features, and social determinants of health. RESULTS: We analyzed 830 visits by 110 patients (median 7 visits per patient [interquartile range 4-10]) over 3.5 years. The provider-directed activity was associated with improved pLCI performance (adjusted β 0.05 [95% confidence interval (95% CI) 0.01, 0.09]; mean 0.74 versus 0.69). Patients with nephritis in multidisciplinary clinic had higher pLCI scores (adjusted β 0.06 [95% CI 0.02, 0.10]) and likelihood of timely follow-up than those in rheumatology (adjusted relative risk [RR] 1.27 [95% CI 1.02, 1.57]). A pLCI score of ≥0.50 was associated with 0.72-fold lower adjusted risk of subsequent prednisone use (95% CI 0.53, 0.93). Minoritized race, public insurance, and living in areas with greater social vulnerability were not associated with reduced care quality or follow-up, but public insurance was associated with higher risk of prednisone use. CONCLUSION: Greater attention to quality metrics is associated with better outcomes in childhood SLE. Multidisciplinary care models with population management may additionally facilitate equitable care delivery.","journal":"Arthritis Care & Research","year":2023,"id":363815,"datarank":0.31191623125197543,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.0,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9507,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1118615,"name":"Shreya A. Varghese","orcid":null,"position":1,"is_corresponding":false},{"id":260227,"name":"Edward M. Behrens","orcid":"0000-0002-4603-7963","position":2,"is_corresponding":false},{"id":718200,"name":"Sabrina Gmuca","orcid":"0000-0003-3533-5698","position":3,"is_corresponding":false},{"id":1118616,"name":"Jane Subak Kennedy","orcid":null,"position":4,"is_corresponding":false},{"id":260214,"name":"Emily J. Liebling","orcid":"0000-0002-6719-1636","position":5,"is_corresponding":false},{"id":394850,"name":"Melissa A. Lerman","orcid":"0000-0003-1378-5292","position":6,"is_corresponding":false},{"id":296082,"name":"Jay Mehta","orcid":"0000-0003-1739-9639","position":7,"is_corresponding":false},{"id":676658,"name":"Beth H. Rutstein","orcid":"0000-0002-3294-7376","position":8,"is_corresponding":false},{"id":372515,"name":"David D. Sherry","orcid":"0000-0001-8223-1715","position":9,"is_corresponding":false},{"id":957936,"name":"Cory Stingl","orcid":"0000-0002-2694-9973","position":10,"is_corresponding":false},{"id":1118234,"name":"Lehn K. Weaver","orcid":"0000-0002-0437-091X","position":11,"is_corresponding":false},{"id":497109,"name":"Pamela F. Weiss","orcid":"0000-0002-9724-0443","position":12,"is_corresponding":false},{"id":970154,"name":"Jon M. Burnham","orcid":"0000-0002-9438-1072","position":13,"is_corresponding":false},{"id":497108,"name":"Joyce C. Chang","orcid":"0000-0002-1691-4814","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:14:32.510714Z","pmid":"37070611","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}