Evidence Based Best Care Practice for Benign Paroxysmal Positional Vertigo
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|ClinicalTrials.gov Identifier: NCT02809599|
Recruitment Status : Completed
First Posted : June 22, 2016
Last Update Posted : April 18, 2019
|Condition or disease||Intervention/treatment||Phase|
|Benign Paroxysmal Positional Vertigo||Behavioral: DIZZTINCT||Not Applicable|
Show Detailed Description
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||7635 participants|
|Intervention Model:||Crossover Assignment|
|Masking:||None (Open Label)|
|Primary Purpose:||Health Services Research|
|Official Title:||Partnered Implementation of Evidence Based Best Care Practice for Benign Paroxysmal Positional Vertigo: A Stepped Wedge, Randomized Controlled Clinical Trial|
|Actual Study Start Date :||October 13, 2016|
|Actual Primary Completion Date :||April 14, 2018|
|Actual Study Completion Date :||April 16, 2018|
No Intervention: Pre-intervention
Patients in hospitals that have not received the intervention (DIZZTINCT) and that meet eligibility criteria will have their medical charts abstracted to assess BPPV processes at the ED Index visit. A random sample of these patients will be contacted by phone for a brief phone interview regarding their recent visit to the Emergency Department for dizziness.
Patients in hospitals that have received the intervention (DIZZTINCT) and that meet eligibility criteria will have their medical charts abstracted to assess the main study outcome, behavior change in medical providers. A random sample of these patients will be contacted by phone for a brief phone interview regarding their recent visit to the Emergency Department for dizziness.
The intervention, DIZZTINCT, is a multi-faceted educational and care-process based intervention designed to improve the guideline-concordant care of patients with BPPV in the emergency department. The intervention includes six main components: the recruitment and training of local champions who will serve as colleague experts in the community; interactive hands-on educational sessions that address BPPV mechanisms, evidence and practice; a high-yield decision-aid web application for self study and point of care use; development of a referral network for follow up care; follow-up educational sessions to review successes and barriers amongst the intervention group; and other resources developed locally in partnership with the community medical providers.
- Likelihood of Receiving a BPPV Care Process [ Time Frame: Index ED Visit (within hours to 2 days) ]Pre-intervention (no intervention) vs. post-intervention (under intervention).The primary endpoint is measured at the individual patient level, and is the presence of documentation of either the Dix-Hallpike test, the Epley Maneuver (or CRM) (since the first step of the CRM is the diagnostic maneuver).
- Outpatient Referral to a BPPV Provider [ Time Frame: Index ED Visit (within hours to 2 days) ]Pre-intervention (no intervention) vs. post-intervention (under intervention) rate of referral to a BPPV provider
- 90-day Cumulative Incidence of Stroke [ Time Frame: 90 days following initial ED discharge home visit for dizziness ]Stroke diagnosed on the index dizziness visits and for post index visit strokes (delayed diagnosis) within the dizziness population aged 45 and older seen in EDs that have received the intervention versus patients seen in EDs that have not received the intervention.
- Stroke at Index ED Dizziness Visit [ Time Frame: Index ED Visit (within hours to 2 days) ]
- ED Length of Stay [ Time Frame: Index ED Visit (within hours to 2 days) ]
- Neuroimaging utilization [ Time Frame: Index ED Visit (within hours to 2 days) ]Was CT, MRI, or vascular imaging performed in the ED
- Inpatient hospitalization Utilization [ Time Frame: Index ED Visit (within hours to 2 days) ]Was the patient admitted to the hospital from the ED
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02809599
|Principal Investigator:||Kevin A Kerber, MD||University of Michigan|
|Principal Investigator:||William Meurer, MD||University of Michigan|