Comparing Effects of Patient-specific Versus Non-patient-specific Computerized Reminder System

NCT ID: NCT01778140

Last Updated: 2013-02-06

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 90 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2012-01-31
• Study Completion Date: 2013-08-31

Brief Summary

The investigators 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.

Detailed Description

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.

Conditions

Radiographic Contrast Agent Nephropathy

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: NONE

Study Groups

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.

Group Type: EXPERIMENTAL

Patient-specific computerized reminder

Intervention Type: OTHER

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.

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.

Group Type: ACTIVE_COMPARATOR

Non-patient-specific computerized reminder

Intervention Type: OTHER

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.

Control Arm

The physicians assigned to this arm will not use and any computerized reminder.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

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.

Intervention Type: 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.

Intervention Type: OTHER

Other Intervention Names

Patient-specific CDSS; Non-patient-specific CDSS

Eligibility Criteria

Inclusion Criteria

• Our intervention targets are physicians but not patients. All physicians working in the hospital may join this trial.

Exclusion Criteria

• The physician who never orders a CT scan or IVU study will be excluded
• The physician who never operates the CPOE by himself or herself will be excluded

• Minimum Eligible Age: 25 Years
• Maximum Eligible Age: 70 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Science and Technology Council, Taiwan

OTHER_GOV

Sponsor Role: collaborator

Taipei Medical University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Yu-Chuan Li

Role: PRINCIPAL_INVESTIGATOR

Taipei Medical University

Locations

Taipei medical university hospital

Taipei, , Taiwan

Countries

Taiwan

Other Identifiers

NSC100-2320-B-038-034

Identifier Type: -

Identifier Source: org_study_id