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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

Brief Summary:
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 or disease Intervention/treatment Phase
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 Not Applicable

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.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 140 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: Making Accurate Problem Lists in the EHR
Study Start Date : May 2010
Actual Primary Completion Date : November 2010
Estimated Study Completion Date : November 2017

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
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

Primary Outcome Measures :
  1. 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 :
  1. 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.

  2. 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

  3. 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.

Information from the National Library of Medicine

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

Inclusion Criteria:

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

Exclusion Criteria:

  • None

Information from the National Library of Medicine

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 identifier (NCT number): NCT01105923

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United States, Massachusetts
Brigham and Women's Hospital
Boston, Massachusetts, United States, 02115
Sponsors and Collaborators
Brigham and Women's Hospital
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Principal Investigator: Adam Wright, PhD Brigham and Women's Hospital
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Adam Wright, Senior Scientist, Brigham and Women's Hospital Identifier: NCT01105923    
Other Study ID Numbers: 2009P001846
First Posted: April 19, 2010    Key Record Dates
Last Update Posted: February 2, 2015
Last Verified: January 2015
Additional relevant MeSH terms:
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Myasthenia Gravis
Bone Diseases, Metabolic
Renal Insufficiency
Heart Failure
Coronary Artery Disease
Anemia, Sickle Cell
Attention Deficit Disorder with Hyperactivity
Vascular Diseases
Cardiovascular Diseases
Heart Diseases
Coronary Disease
Myocardial Ischemia
Arterial Occlusive Diseases
Bone Diseases
Musculoskeletal Diseases
Metabolic Diseases
Attention Deficit and Disruptive Behavior Disorders
Neurodevelopmental Disorders
Mental Disorders
Nervous System Diseases
Hematologic Diseases
Genetic Diseases, Inborn
Anemia, Hemolytic, Congenital
Anemia, Hemolytic