Comparing Effects of Patient-specific Versus Non-patient-specific Computerized Reminder System
Recruitment status was: Active, not recruiting
|Radiographic Contrast Agent Nephropathy||Other: Patient-specific computerized reminder Other: Non-patient-specific computerized reminder|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Health Services Research
|Official Title:||Randomized Controlled Trial: Comparing Effects of Patient-Specific Versus Non-Patient-Specific Computerized Reminder System to Reduce Contrast-Induced Nephropathy|
- The percentage of contrast-enhanced imaging(CEI) orders with high CIN risk [ Time Frame: 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
- The order elimination rate of high CIN risk orders attributed to the computerized reminder [ Time Frame: 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.
|Study Start Date:||January 2012|
|Estimated Study Completion Date:||August 2013|
|Estimated Primary Completion Date:||July 2013 (Final data collection date for primary outcome measure)|
Experimental: 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.
Other: Patient-specific computerized reminder
The intervention targets are physicians,not patients. This CDSS alerts physicians only when the patient with high risk of contrast-induced-nephropathy(CIN) is encountered. On the contrast, the CDSS will not alert when the patient without CIN risk is encountered.
Other Name: Patient-specific CDSS
Active Comparator: 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.
Other: Non-patient-specific computerized reminder
The non-patient-specific computerized reminder always pops up to remind physicians to check their patient's CIN risk no matter what CIN risk is.
Other Name: Non-patient-specific CDSS
No Intervention: Control Arm
The physicians assigned to this arm will not use and any computerized reminder.
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.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01778140
|Taipei medical university hospital|
|Taipei, Taiwan, 110|
|Principal Investigator:||Yu-Chuan Li||Taipei Medical University|