Randomized Controlled Trial: Comparing Effects of Patient-Specific Versus Non-Patient-Specific Computerized Reminder System to Reduce Contrast-Induced Nephropathy
试验速览
- 阶段
- 不适用
- 入组人数
- 90
- 试验地点
- 1
- 主要终点
- The percentage of contrast-enhanced imaging(CEI) orders with high CIN risk
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 25 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Our intervention targets are physicians but not patients. All physicians working in the hospital may join this trial.
排除标准
- •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
研究组 & 干预措施
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.
干预措施: Patient-specific computerized reminder (Other)
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.
干预措施: Non-patient-specific computerized reminder (Other)
Control Arm
The physicians assigned to this arm will not use and any computerized reminder.
结局指标
主要结局
The percentage of contrast-enhanced imaging(CEI) orders with high CIN risk
时间窗: 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
次要结局
- 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)