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Using Video for Triage of Children With Fever at the Medical Helpline 1813 in Copenhagen, Denmark

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ClinicalTrials.gov Identifier: NCT04074239
Recruitment Status : Recruiting
First Posted : August 30, 2019
Last Update Posted : January 31, 2020
Sponsor:
Collaborators:
Copenhagen University Hospital, Hvidovre
Copenhagen University Hospital at Herlev
Rigshospitalet, Denmark
University of Copenhagen
Information provided by (Responsible Party):
Emergency Medical Services, Capital Region, Denmark

Brief Summary:

Background:

The Medical Helpline 1813 in Copenhagen, Denmark handles acute, non-life threatening medical emergencies. Approx. 200,000 calls/year concern children, and about 30% are referred to a pediatric urgent care center. However, most of these children have very mild symptoms, which require neither treatment nor tests, merely parental guidance.

Initial assessment; triage, of children on the phone is difficult, especially when the operator does not know the child or family, and when it is difficult to describe the symptoms in medical terms. This may result in too many not-so-sick children and too few more severely sick children getting sent to hospital.

Many parents are very worried about their sick child, but it is not known if this worry can be integrated in the triage process.

Purpose:

It will be studied if triage by video calls; video triage; provide greater security for parents and call operators so that more children can stay at home after medical guidance, causing at least 10% fewer visits to pediatric urgent care centers. The degree of worry of the parents will also be registered.

Method:

Children aged 3 months to 5 years with fever will be triaged by either video or telephone every other day, to compare the results between these to otherwise similar groups. Operators and parents answer surveys about their experiences.

Yield:

Video triage can "give eyes to the operators" and revolutionize telephone triage. The study may result in fewer children referred to hospitals, more appropriate use of resources and better experiences for the families.


Condition or disease Intervention/treatment Phase
Fever Telemedicine Pediatrics Triage Other: Video triage Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 744 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: The operators at the medical helpline 1813 will triage children meeting the inclusion criteria by video every other day they are at work, and by telephone the other days. The children will hence be randomized to either video or telephone depending on what day they are calling and which operator they are talking to.
Masking: None (Open Label)
Primary Purpose: Other
Official Title: Using Video Transmission for Optimized Telephone Triage of Children With Fever at the Medical Helpline 1813 in Copenhagen, Denmark
Actual Study Start Date : August 5, 2019
Estimated Primary Completion Date : February 2020
Estimated Study Completion Date : February 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Fever

Arm Intervention/treatment
Experimental: Video triage
The sick child will be triaged on video by the operator.
Other: Video triage
The operator at the Medical Helpline will offer the parent who's calling regarding the sick child to assess the child on video, as compared to the routine way; on the telephone.

No Intervention: Telephone triage
The sick child will be triaged solely on telephone by the operator.



Primary Outcome Measures :
  1. Disposition [ Time Frame: Disposition is registered by the operator immediately after the call for all patients included, throughout the project period.. ]
    Difference between the arms in the percentage of children that stays at home the first 8 hours after the call, i.e. referral to self-care or GP.


Secondary Outcome Measures :
  1. Admittance [ Time Frame: The hospital chart of all children is read within 2-8 days after the call for all patients included, throughout the project period. ]
    Difference between the arms in the percentage of children that is admitted directly to a pediatric emergency department

  2. Hospital visits [ Time Frame: The hospital chart of all children is read within 2-8 days after the call for all patients included, throughout the project period.. ]
    Difference between the two arms in how many children that were seen at a hospital at 8 and 48 hours after the call. Also, what temperature did they have, what diagnoses did they receive, were they admitted, and if so for how long, were any children transferred to ICU, and did any children die?

  3. Treatment [ Time Frame: The hospital chart of all children is read within 2-8 days after the call for all patients included, throughout the project period.. ]
    The difference in percentage between the two arms in how many children that received treatment or paraclinical tests, or got a prescription.

  4. Operators: satisfaction [ Time Frame: The operators fill out a survey immediately after the call for all patients included, throughout the project period.. ]
    The difference in percentage between the two arms in how many operators that were satisfied with the call to an acceptable extent or better.

  5. Operators: DOW [ Time Frame: The operators fill out a survey immediately after the call for all patients included, throughout the project period.. ]
    Presentation of the DOW in the two groups, and if there are any differences.

  6. Operators: safety [ Time Frame: The operators fill out a survey immediately after the call for all patients included, throughout the project period.. ]
    How many operators state that they feel more safe about the disposition choice when having seen the child on video.

  7. Parents: satisfaction with the contact to 1813 [ Time Frame: The parents fill out a survey immediately after the call for all patients included, throughout the project period.. ]
    The difference in percentage between the two arms in how many parents that were satisfied with the contact to 1813 to an acceptable extent or better.

  8. Parents: Questions getting answered [ Time Frame: The parents fill out a survey immediately after the call for all patients included, throughout the project period.. ]
    The difference in percentage between the two arms in how many parents that felt that they got answers to their questions during the call to 1813 to an acceptable extent or better.

  9. Parents: satisfaction about assessment [ Time Frame: The parents fill out a survey immediately after the call for all patients included, throughout the project period.. ]
    The difference in percentage between the two arms in how many parents that felt safe about the assessment of their child to an acceptable extent or better.

  10. Parents: satisfaction about the plan [ Time Frame: The parents fill out a survey immediately after the call for all patients included, throughout the project period.. ]
    The difference in percentage between the two arms in how many parents that felt safe about the plan laid out for their child to an acceptable extent or better.

  11. Parents: DOW before call [ Time Frame: The parents fill out a survey immediately after the call for all patients included, throughout the project period.. ]
    The difference in percentage between the two arms in how they grade their worry BEFORE having talked to the operator at 1813.

  12. Parents: DOW after call [ Time Frame: The parents fill out a survey immediately after the call for all patients included, throughout the project period.. ]
    The difference in percentage between the two arms in how they grade their worry AFTER having talked to the operator at 1813.

  13. Parents: video as a permanent options [ Time Frame: The parents fill out a survey immediately after the call for all patients included, throughout the project period.. ]
    The difference in percentage between the two arms in how many that think that video should be made a permanent option at 1813

  14. Economical consequences [ Time Frame: Can be calculated when the project no longer enrolls children, the inclusion is expected to be ready after approximately 4 months. ]
    Calculation of how many visits at the hospital that could be avoided because of video triage.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   3 Months to 5 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Parents state that the child has fever.
  • Parents are calling from a smartphone with Apple, Windows or Android operating system.

Exclusion Criteria:

  • The child has already participated.
  • The parent does not call from a Danish telephone number.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04074239


Contacts
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Contact: Caroline Gren, M.D. +4560813190 ida.caroline.gren.02@regionh.dk
Contact: Dina Cortes, M.D. +4523707630 dina.cortes@regionh.dk

Locations
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Denmark
Emergency Medical Services Recruiting
Copenhagen, Denmark
Contact: Caroline Gren, M.D.    +4560813190    ida.caroline.gren.02@regionh.dk   
Contact: Fredrik Folke, M.D.    +4528182978    ff@heart.dk   
Principal Investigator: Caroline Gren, M.D.         
Sponsors and Collaborators
Emergency Medical Services, Capital Region, Denmark
Copenhagen University Hospital, Hvidovre
Copenhagen University Hospital at Herlev
Rigshospitalet, Denmark
University of Copenhagen
Investigators
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Study Chair: Dina Cortes, M.D. Department of Pediatrics, Copenhagen University Hopsital Hvidovre
Publications:
Rasmussen MV. Data, controlling and IT section, Copenhagen Emergency Services. January 2019.
Boisen AS. Implementeringen af Enstrenget og Visiteret Akutsystem i Region Hovedstaden - en analyse af samspillet mellem organisatorisk forandring og brugeradfærd. Institut for Folkesundhedsvidenskab, Københavns Universitet; 2015
Børns brug af regionale sundhedsydelser. Center for Sundhed - Enhed for Tværsektoriel Udvikling. Region Hovedstaden. 2017. https://www.regionh.dk/til-fagfolk/Sundhed/Tvaersektorielt-samarbejde/samarbejdspulje-og-forebyggelse/Documents/rapport-boerns-brug-regionale-sundhedsydelser.pdf
Analyse af børns brug af sundhedsydelser. Center for Sundhed - Enhed for Tværsektoriel Udvikling. Region Hovedstaden. 2017. https://www.regionh.dk/til-fagfolk/Sundhed/Tvaersektorielt-samarbejde/samarbejdspulje-og-forebyggelse/Documents/analyse_af_boerns_brug_af_sundhedsydelser.pdf
Lægehåndbogen. Feber hos børn. https://www.sundhed.dk/sundhedsfaglig/laegehaandbogen/paediatri/symptomer-og-tegn/feber-hos-boern/
Gamst-Jensen H. Patients' self-assessment of illness and injury in telephone triage using a novel degree-of-worry scale. Ph.D. dissertation. Faculty of Health and Medical Science, University of Copenhagen; 2018.
Regioner på vej med ny app: Hver tredje konsultation kan ske online. Dagens Medicin. 2018. https://dagensmedicin.dk/danske-regioner-lancerer-ny-app-hver-tredje-konsultation-kan-ske-online/
Videokonsultationer skal få praktiserende læger til Mors og til andre lægedækningstruede områder. Region Nordjylland. http://rn.dk/service/nyhedsliste-rn/nyhed?id=48723d23-88da-4759-a685-9c9336bc6093

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Responsible Party: Emergency Medical Services, Capital Region, Denmark
ClinicalTrials.gov Identifier: NCT04074239    
Other Study ID Numbers: Video fever
First Posted: August 30, 2019    Key Record Dates
Last Update Posted: January 31, 2020
Last Verified: January 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Emergency Medical Services, Capital Region, Denmark:
telemedicine
Triage
Call centers
Fever
Pediatrics
Additional relevant MeSH terms:
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Fever
Body Temperature Changes
Signs and Symptoms