{"doi":"10.1017/cts.2023.679","title":"Real-world data to evaluate effects of a multi-level dissemination strategy on access, outcomes, and equity of monoclonal antibodies for COVID-19","abstract":"Abstract Introduction: Multi-level dissemination strategies are needed to increase equitable access to effective treatment for high-risk outpatients with COVID-19, particularly among patients from disproportionately affected communities. Yet assessing population-level impact of such strategies can be challenging. Methods: In collaboration with key contributors in Colorado, we conducted a retrospective cohort study to evaluate a multi-level dissemination strategy for neutralizing monoclonal antibody (mAb) treatment. Real-world data included county-level, de-identified output from a statewide mAb referral registry linked with publicly available epidemiological data. Outcomes included weekly number of mAb referrals, unique referring clinicians, and COVID-19 hospitalization rates. We assessed weekly changes in outcomes after dissemination strategies launched in July 2021. Results: Overall, mAb referrals increased from a weekly average of 3.0 to 15.5, with an increase of 1.3 to 42.1 additional referrals per county in each post-period week ( p < .05). Number of referring clinicians increased from a weekly average of 2.2 to 9.7, with an additional 1.5 to 22.2 unique referring clinicians observed per county per week beginning 5 weeks post-launch ( p < .001). Larger effects were observed in communities specifically prioritized by the dissemination strategies. There were no observed differences in COVID-19 hospitalization rates between counties with and without mAb treatment sites. Conclusion: Real-world data can be used to estimate population impact of multi-level dissemination strategies. The launch of these strategies corresponded with increases in mAb referrals, but no apparent population-level effects on hospitalization outcomes. Strengths of this analytic approach include pragmatism and efficiency, whereas limitations include inability to control for other contemporaneous trends.","journal":"Journal of Clinical and Translational Science","year":2023,"id":383954,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":29.844511487584125,"corpus_rank":8690,"citation_count":2,"citer_count":1,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5201,"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":943248,"name":"Chelsea Sobczak","orcid":"0000-0001-9013-902X","position":1,"is_corresponding":false},{"id":1151642,"name":"Lindsey Whittington","orcid":null,"position":2,"is_corresponding":false},{"id":1151643,"name":"Rachel L. Bowyer","orcid":null,"position":3,"is_corresponding":false},{"id":1151644,"name":"Ramona Koren","orcid":null,"position":4,"is_corresponding":false},{"id":1151258,"name":"Joel A. Begay","orcid":"0000-0002-4899-330X","position":5,"is_corresponding":false},{"id":260420,"name":"Hillary D. Lum","orcid":"0000-0001-5637-3912","position":6,"is_corresponding":false},{"id":105999,"name":"Adit A. Ginde","orcid":"0000-0003-2325-206X","position":7,"is_corresponding":false},{"id":562767,"name":"Matthew K. Wynia","orcid":"0000-0003-3307-069X","position":8,"is_corresponding":false},{"id":298639,"name":"Bethany M. Kwan","orcid":"0000-0002-4013-5618","position":9,"is_corresponding":false},{"id":1145954,"name":"Mika K. Hamer","orcid":"0000-0003-2234-1095","position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":null,"created_at":"2026-07-19T01:17:33.041385Z","pmid":"38229899","pmcid":"PMC10789982","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":[]}