Grasshopper: a Novel Clinical Dashboard for Radiologists

Not Applicable

• Conditions: Chest Infection; Pulmonary Edema - Acute

• Registration Number: NCT06785246
• Lead Sponsor: Kaiser Permanente

Brief Summary

Does a radiology clinical dashboard increase radiologist use of specific reporting language for chest X-rays (CXRs) and thereby decrease rates of unnecessary Emergency Department (ED) prescriptions and follow-up imaging?

Detailed Description

Chest X-rays (CXR) are the most common radiologic exam, comprising nearly one third of total KPNC imaging volume. Despite high CXR utilization, diagnostic yield is frequently low, partly due to the paucity of clinical information provided to radiologists at the time of CXR interpretation, resulting in frequent nonspecific CXR assessments which include terms like "opacities" instead of diagnostic terms such as "pulmonary edema" or "pneumonia". This may contribute to over-treatment and unnecessary follow-up CT imaging. This study proposes the production deployment, active promotion, and evaluation of an innovative clinical dashboard called Grasshopper for radiologists to provide pertinent clinical information at the time of CXR interpretation. The dashboard leverages the electronic medical record to programmatically retrieve, and display select clinical notes, patient lab values, and vital signs. The Grasshopper study aims to prospectively evaluate the impact of Grasshopper on CXR report specificity in ED settings across 15 KPNC service areas, and on downstream care process measures such as prescription and imaging utilization.

Study Timeline

• Study Start: 2024-01-01
• Status Verified: 2025-01
• Study First Submitted: 2025-01-07
• Study First Submitted QC: 2025-01-17
• Last Update Submitted: 2025-01-17
• Study First Posted: 2025-01-21
• Last Update Posted: 2025-01-21
• Primary Completion: 2025-12-31
• Study Completion: 2025-12-31

Recruitment & Eligibility

• Status: ENROLLING_BY_INVITATION
• Sex: All
• Target Recruitment: 100000

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SEQUENTIAL

Primary Outcome Measures

Name	Time	Method
Number of Diagnostic CXR Reports	Through study completion, an average of 18 months.	Number of CXR reports that employ diagnostic terms in the report impression (e.g. "negative", "pneumonia", "pulmonary edema"), compared with baseline standard of care report impressions.

Secondary Outcome Measures

Name	Time	Method
Number of Prescriptions after Stat CXR	Through study completion, at an average of 18 months.	Number of antibiotic and diuretic prescriptions the patient receives after having undergone a stat CXR, compared with baseline standard of care.
Number of CT Imaging exams after Stat CXR	Through study completion, at an average of 18 months.	Number of follow-up CT imaging exams that a patient receives after having undergone a stat CXR, compared with baseline standard of care.

Trial Locations

Locations (1)

Kaiser Permanente Northern California Division of Research; 🇺🇸 Pleasanton, California, United States