Comparing Effects of Patient-specific Versus Non-patient-specific Computerized Reminder System

Not Applicable

• Conditions: Radiographic Contrast Agent Nephropathy

• Registration Number: NCT01778140
• Lead Sponsor: Taipei Medical University

Brief Summary

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.

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.

Study Timeline

• Study Start: 2012-01
• Study First Submitted: 2012-12-26
• Study First Submitted QC: 2013-01-24
• Study First Posted: 2013-01-29
• Status Verified: 2013-02
• Last Update Submitted: 2013-02-05
• Last Update Posted: 2013-02-06
• Primary Completion: 2013-07
• Study Completion: 2013-08

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 90

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
The percentage of contrast-enhanced imaging(CEI) orders with high CIN risk	Physicains who participated in this trial will be followed for an expected average of 12 months	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

Secondary Outcome Measures

Name	Time	Method
The order elimination rate of high CIN risk orders attributed to the computerized reminder	Physicains who participated in this trial will be followed for an expected average of 12 months	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.

Trial Locations

Locations (1)

Taipei medical university hospital; 🇨🇳 Taipei, Taiwan