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Study of an Intervention to Improve Problem List Accuracy and Use (MAPLE)

This study is ongoing, but not recruiting participants.
Information provided by (Responsible Party):
Adam Wright, Brigham and Women's Hospital Identifier:
First received: April 15, 2010
Last updated: January 30, 2015
Last verified: January 2015
The aim of this study is to identify patients with problem list gaps and intervene to correct these gaps by creating clinical decision support interventions that alert providers to likely problem list gaps and offer clinicians the opportunity to correct them. The investigators will randomize the clinics that will receive the intervention and formally evaluate the study after a period of 6 months for improved problem list completeness to determine the effectiveness of our intervention.

Condition Intervention
Attention Deficit Disorder With Hyperactivity
Breast Cancer
Coronary Artery Disease
Congestive Heart Failure
Myasthenia Gravis
Renal Failure
Renal Insufficiency
Sickle Cell Disease
Other: MAPLE

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Diagnostic
Official Title: Making Accurate Problem Lists in the EHR

Resource links provided by NLM:

Further study details as provided by Brigham and Women's Hospital:

Primary Outcome Measures:
  • Intervention acceptance [ Time Frame: 6 months (May 2010-Nov2010) ]
    Of those providers who were shown (or who would have been shown, for the control group) the intervention, the number that added a problem across control and intervention groups.

Secondary Outcome Measures:
  • Problem list prevalence [ Time Frame: pre and post intervention ]
    Number of patients with selected problems on their problem list pre and post intervention across intervention and control groups.

  • Problem list incidence [ Time Frame: pre and post intervention ]
    For the conditions of interest, the percent of patients that had the problem added during the study period

  • Quality improvement based on problem list accuracy/completion [ Time Frame: post intervention ]
    For those with problems added due to the intervention, the number of new triggered reminders or other clinical actions.

Estimated Enrollment: 140
Study Start Date: May 2010
Estimated Study Completion Date: November 2017
Primary Completion Date: November 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Receive CDS intervention
Providers in clinics that will receive the CDS alert, as their clinic was randomized into our study.
Other: MAPLE
MAPLE is a CDS intervention within the EHR that will alert providers to problem lists gaps and present an opportunity to correct them.
No Intervention: No CDS intervention

Detailed Description:

The clinical problem list is a cornerstone of the problem-oriented medical record. Problem lists are used in a variety of ways throughout the process of clinical care. In addition to its use by clinicians, the problem list is also critical for decision support and quality measurement.

Patients with gaps in their problem list face significant risks. For example, if a hypothetical patient has diabetes properly documented, his clinician would receive appropriate alerts and reminders to guide care. Additionally, the patient might be included in special care management programs and the quality of care provided to him would be measured and tracked. Without diabetes on his problem list, he might receive none of these benefits.

In this study, the investigators developed an clinical decision support intervention that will identify patients with problem lists gaps. The investigators will alert providers of these likely gaps and offer providers the opportunity to correct them.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Independent healthcare provider (physician, NP, PA)
  • Practices at participating site

Exclusion Criteria:

  Contacts and Locations
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Please refer to this study by its identifier: NCT01105923

United States, Massachusetts
Brigham and Women's Hospital
Boston, Massachusetts, United States, 02115
Sponsors and Collaborators
Brigham and Women's Hospital
Principal Investigator: Adam Wright, PhD Brigham and Women's Hospital
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Adam Wright, Senior Scientist, Brigham and Women's Hospital Identifier: NCT01105923     History of Changes
Other Study ID Numbers: 2009P001846
Study First Received: April 15, 2010
Last Updated: January 30, 2015

Additional relevant MeSH terms:
Heart Failure
Coronary Artery Disease
Myocardial Ischemia
Coronary Disease
Attention Deficit Disorder with Hyperactivity
Renal Insufficiency
Anemia, Sickle Cell
Bone Diseases, Metabolic
Myasthenia Gravis
Heart Diseases
Cardiovascular Diseases
Arterial Occlusive Diseases
Vascular Diseases
Bone Diseases
Musculoskeletal Diseases
Attention Deficit and Disruptive Behavior Disorders
Neurodevelopmental Disorders
Mental Disorders
Kidney Diseases
Urologic Diseases
Anemia, Hemolytic, Congenital
Anemia, Hemolytic
Hematologic Diseases
Genetic Diseases, Inborn processed this record on April 21, 2017