NCT01785368已完成不适用
Implementing Referral Guidelines for Imaging Exams Requested Via the Emergency Department: Impact on Exam Relevance and Associated Delays
Centre Hospitalier Universitaire de Nīmes2 个研究点 分布在 1 个国家目标入组 8,549 人开始时间: 2013年10月1日最近更新:
适应症
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 8,549
- 试验地点
- 2
- 主要终点
- Change in the % of initial, suspected diagnoses that are confirmed positive by the requested exam
研究概览
简要总结
The main objective of this study is to evaluate the impact of the implementation of referral guidelines for imaging exams requested by the emergency department on exam relevance. The latter is assessed via the rate of suspected diagnoses that are confirmed by the requested exam.
详细描述
The secondary objectives of this study are to assess the impact of the implementation of referral guidelines for imaging exams requested by the emergency department on the following:
A. How exam results are classified in relation to the initial, suspected diagnosis.
B. Further aspects of exam relevance.
C. Delays associated with exams
D. Changes in practice in terms of type of examination, clinical situations, the number of tests ordered per patient, and emergency situations
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •The patient (or his/her guardian/parent/person-of-trust) was correctly informed about the study
- •A participating ER doctor has requested an imaging exam for the patient during one of the trial observation periods (ie the "before" period or the "after" period).
排除标准
- •The patient is under judicial protection
- •The patient (or his/her guardian/parent/person-of-trust) refuses to participate in the study
结局指标
主要结局
Change in the % of initial, suspected diagnoses that are confirmed positive by the requested exam
时间窗: baseline (days 0 to 30) versus the 6th month after implementation of guidelines
Measured over an observation period of 1 month.
次要结局
- Change in the classification of exam results in relation to initial, suspected diagnosis(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the frequency of each type of clinical situation associated with imaging exams.(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the % agreement between the clinical situation coded by the emergency doctor and the radiologist(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the % of requested exams that do not conform with the exam recommended by the implemented guidelines(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the % of exams performed identical to the exam requested(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the average delay between the time marked on the request and the distribution of written exam results.(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the number of requests for imaging exams made by the emergency department(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the positivity rate for each suspected diagnosis(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the frequency of imaging exams requested per type of emergency situation(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the frequency of injection of contrast agents(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the frequency of each type of exam carried out.(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the average number of imaging exams requested per patient(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the total radiation exposure per patient(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the average delay between the time marked on the request and the exam.(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the number of admissions in the emergency department(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the % of patients admitted to the emergency department and needing an imaging exam.(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
- Change in the frequency of patients requiring contrast agents AND whose exam results are classified as "the suspected diagnosis was not confirmed, exam normal"(baseline (days 0 to 30) versus the 6th month after implementation of guidelines)
研究者
研究点 (2)
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