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Table 3 Level of evidence as classified by the study design for the publications included in this review. A level of evidence as ‘0’ was assigned if article could not be assessed because it was (a) a peer-review publication that stated translational benefits of the LHS but no figures provided, or (b) it was a non-peer reviewed article i.e. grey literature

From: Learning health systems using data to drive healthcare improvement and impact: a systematic review

  LHS Study GRADE Level of Evidence Notes
1 ePRO Duke cancer clinics LHS [19] Observational, case series pre/post outcomes low  
2 Surgical Care and Outcomes Assessment Program (SCOAP) [20] Observational, case series low  
3 ImproveCareNow Chronic Care Network [21] Observational, case series low  
[22] Qualitative case evaluation, examining LHS user interaction, technology, content management, and community engagement ? Qualitative evaluation
4 NUCATS Institute LHS [24] Observational, case series low  
[25] Observational, case series low  
[23] RCT high  
[26] Observational, case series low  
5 Ottawa Hospital Lung Cancer LHS [28] Observational, case series pre/post outcomes low  
[27] Observational, case series pre/post outcomes low  
6 PEDS-CHOIR [29] Observational, cross-sectional cases low  
7 University of Alabama at Birmingham Hospital, USA [30] Improvements stated, no figures provided 0 No figures provided
8 ePPOC [31] Observational, case series low  
9 Community Health Applied Research Network (CHARN) [33] Qualitative evaluation of the adoption, expansion, and diffusion of the national LHS model ? Qualitative evaluation
[32] Observational, cross-sectional cases, other improvements stated but no figures reported low  
10 KPNC 30 primary care practices at 13 medical facilities across four counties [34] Pragmatic, provider-randomized, multi-site clinical trial high  
11 Connected Health Cities [35] Correspondence article in journal 0 Grey literature
[61] Final report, observational, case studies reported 0 Grey literature
12 PCORnet® [38] Interrupted time series without parallel control low  
[39] Two of more single arms low  
[36] RCT, large multisite high  
[37] RCT, large multisite high  
13 Swedish Rheumatology Quality Register [40] Improvements stated, no figures provided 0 No figures provided
[42] Observational, 3 case descriptions provided low  
[41] Observational, case series low  
14 University of Wisconsin Health LHS [46] Observational, case series low  
[44] Interrupted time series without parallel control low  
[43] Cluster RCT, 4 sites high  
[45] Observational, case series pre/post outcomes low  
15 Wound Care LHS [48] Observational, case series low  
[47] Observational, case series low  
16 Alberta Strategic Clinical Networks [50] Observational, case series pre/post outcomes low  
[49] Observational, case series pre/post outcomes.
Thematic analysis on documents & interviews
low Mixed-methods
17 Geisinger Health Systems LHS [51] Improvements stated, no figures provided 0 No figures provided
18 Cystic Fibrosis Foundation Patient Registry [52] Observational, case series low  
19 Kaiser Permanente Northern California [53] Interrupted time series without parallel control low  
[54] Observational, case series pre/post outcomes low  
20 Distributed Ambulatory Research in Therapeutics Network (DARTNet) [55] Observational, case series low  
21 Optum Labs LHS [56] Improvements stated, no figures provided 0 No figures provided
[57] Comparative study with concurrent controls medium  
[58] Observational, case series low  
23 IDEA4PS [59] Observational, case series low  
[60] Observational, case series pre/post outcomes.
Ethnography and interviews
low Mixed-methods
  1. Level of evidence was not determined for qualitative approaches and instead notes on the qualitative approach are provided