Comparing Effects of Patient-specific Versus Non-patient-specific Computerized Reminder System
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Purpose
The investigators hypothesize that a Clinical Decision Support System (CDSS) designed with "Patient-Specific" reminders yields superior performance than that with "Non-patient-specific" reminders in preventing contrast-induced nephropathy.
| Condition | Intervention |
|---|---|
|
Radiographic Contrast Agent Nephropathy |
Other: Patient-specific computerized reminder Other: Non-patient-specific computerized reminder |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Health Services Research |
| Official Title: | Randomized Controlled Trial: Comparing Effects of Patient-Specific Versus Non-Patient-Specific Computerized Reminder System to Reduce Contrast-Induced Nephropathy |
- The percentage of contrast-enhanced imaging(CEI) orders with high CIN risk [ Time Frame: Physicains who participated in this trial will be followed for an expected average of 12 months ] [ Designated as safety issue: Yes ]The number of CEI ordered for patients at high CIN risk, divided by the total number of CEI orders. [CEI]: contrast-enhanced image studies,such as CT or IVU. [CIN]: contrast-induced nephropathy
- The order elimination rate of high CIN risk orders attributed to the computerized reminder [ Time Frame: Physicains who participated in this trial will be followed for an expected average of 12 months ] [ Designated as safety issue: Yes ]The number of CEI orders with high CIN risk cancelled by the physician attributed to our computerized reminder, divided by the total number of CEI orders with high CIN risk.
| Estimated Enrollment: | 90 |
| Study Start Date: | January 2012 |
| Estimated Study Completion Date: | August 2013 |
| Estimated Primary Completion Date: | July 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Patient-specific reminder
Intervention: Patient-specific computerized reminder. The physicians assigned to this arm will use the patient-specific CDSS on CPOE. The patient-specific reminder is designed as a real-time CDSS implemented on CPOE to monitor physician's contrast-enhanced image study orders. Computerized pop-up reminders provide the patient-specific CIN risk profile and optimal decision options which are generated when patients with high risk or with unknown risk of CIN are encountered.
|
Other: Patient-specific computerized reminder
The intervention targets are physicians,not patients. This CDSS alerts physicians only when the patient with high risk of contrast-induced-nephropathy(CIN) is encountered. On the contrast, the CDSS will not alert when the patient without CIN risk is encountered.
Other Name: Patient-specific CDSS
|
|
Active Comparator: Non-patient-specific reminder
Intervention: Non-patient-specific Computerized reminder. The physicians assigned to this arm will use the Non-patient-specific reminders through CPOE. Non-patient-specific reminders always pops up to remind physicians to check their patient's CIN risk no matter what CIN risk is.
|
Other: Non-patient-specific computerized reminder
The non-patient-specific computerized reminder always pops up to remind physicians to check their patient's CIN risk no matter what CIN risk is.
Other Name: Non-patient-specific CDSS
|
|
No Intervention: Control Arm
The physicians assigned to this arm will not use and any computerized reminder.
|
Detailed Description:
We hypothesize that a clinical decision support system (CDSS) designed with "Patient-specific" reminders yields superior performance than that with "Non-patient-specific" reminders in preventing contrast-induced nephropathy.
A 3-arm randomized controlled trial (RCT) will be performed by cluster randomization using physicians as the unit of allocation. Physicians in 3 university medical centers will be randomly assigned into 1) patient-specific arm with Anti Contrast-Induced-Nephropathy(Anti-CIN) reminder, 2) non-patient-specific reminder arm, and 3) the control arm without any reminders, respectively.
The patient-specific alert, Anti-CIN system, is designed as a real-time CDSS implementation on CPOE for monitoring physician's contrast-enhanced CT and IVP orders. Computerized pop-up reminders provide the patient-specific encounters with optimal decision options when patients are at a high CIN risk or patients with unknown risk factors are encountered. Non-patient-specific reminders always pop up no matter whether the patient is at a high risk or not.
Eligibility| Ages Eligible for Study: | 25 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Our intervention targets are physicians but not patients. All physicians working in the hospital may join this trial.
Exclusion Criteria:
- The physician who never orders a CT scan or IVU study will be excluded
- The physician who never operates the CPOE by himself or herself will be excluded
Contacts and Locations| Taiwan | |
| Taipei medical university hospital | |
| Taipei, Taiwan, 110 | |
| Principal Investigator: | Yu-Chuan Li | Taipei Medical University |
More Information
No publications provided
| Responsible Party: | Taipei Medical University |
| ClinicalTrials.gov Identifier: | NCT01778140 History of Changes |
| Other Study ID Numbers: | NSC100-2320-B-038-034 |
| Study First Received: | December 26, 2012 |
| Last Updated: | February 5, 2013 |
| Health Authority: | Taiwan: Department of Health |
Keywords provided by Taipei Medical University:
|
Clinical Decision Support Systems Contrast-induced nephropathy |
Additional relevant MeSH terms:
|
Kidney Diseases Urologic Diseases |
ClinicalTrials.gov processed this record on May 21, 2013