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

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01105923
Recruitment Status : Unknown
Verified January 2015 by Adam Wright, Brigham and Women's Hospital.
Recruitment status was:  Active, not recruiting
First Posted : April 19, 2010
Last Update Posted : February 2, 2015
Information provided by (Responsible Party):
Adam Wright, Brigham and Women's Hospital

April 15, 2010
April 19, 2010
February 2, 2015
May 2010
November 2010   (Final data collection date for primary outcome measure)
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.
Same as current
Complete list of historical versions of study NCT01105923 on Archive Site
  • 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.
Same as current
Not Provided
Not Provided
Study of an Intervention to Improve Problem List Accuracy and Use
Making Accurate Problem Lists in the EHR
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.

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.

Not Applicable
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
  • Attention Deficit Disorder With Hyperactivity
  • Asthma
  • COPD
  • Breast Cancer
  • Coronary Artery Disease
  • Congestive Heart Failure
  • Diabetes
  • Glaucoma
  • Hemophilia
  • Hypertension
  • Hyperthyroidism
  • Hypothyroidism
  • Myasthenia Gravis
  • Osteoporosis
  • Osteopenia
  • Renal Failure
  • Renal Insufficiency
  • Sickle Cell Disease
  • Stroke
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.
  • Experimental: Receive CDS intervention
    Providers in clinics that will receive the CDS alert, as their clinic was randomized into our study.
    Intervention: Other: MAPLE
  • No Intervention: No CDS intervention
Wright A, Pang J, Feblowitz JC, Maloney FL, Wilcox AR, McLoughlin KS, Ramelson H, Schneider L, Bates DW. Improving completeness of electronic problem lists through clinical decision support: a randomized, controlled trial. J Am Med Inform Assoc. 2012 Jul-Aug;19(4):555-61. doi: 10.1136/amiajnl-2011-000521. Epub 2012 Jan 3.

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
Unknown status
Same as current
November 2017
November 2010   (Final data collection date for primary outcome measure)

Inclusion Criteria:

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

Exclusion Criteria:

Sexes Eligible for Study: All
18 Years and older   (Adult, Older Adult)
Contact information is only displayed when the study is recruiting subjects
United States
Not Provided
Not Provided
Adam Wright, Brigham and Women's Hospital
Brigham and Women's Hospital
Not Provided
Principal Investigator: Adam Wright, PhD Brigham and Women's Hospital
Brigham and Women's Hospital
January 2015

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP