Comparing Effects of Patient-specific Versus Non-patient-specific Computerized Reminder System
|ClinicalTrials.gov Identifier: NCT01778140|
Recruitment Status : Unknown
Verified February 2013 by Taipei Medical University.
Recruitment status was: Active, not recruiting
First Posted : January 29, 2013
Last Update Posted : February 6, 2013
|Condition or disease||Intervention/treatment||Phase|
|Radiographic Contrast Agent Nephropathy||Other: Patient-specific computerized reminder Other: Non-patient-specific computerized reminder||Not Applicable|
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 Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||90 participants|
|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|
|Study Start Date :||January 2012|
|Estimated Primary Completion Date :||July 2013|
|Estimated Study Completion Date :||August 2013|
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.
- 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.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01778140
|Taipei medical university hospital|
|Taipei, Taiwan, 110|
|Principal Investigator:||Yu-Chuan Li||Taipei Medical University|