Trial Outcomes & Findings for Nudging Provider Adoption of Clinical Decision Support (NCT NCT05203185)
NCT ID: NCT05203185
Last Updated: 2023-06-26
Results Overview
The tool is considered adopted during a patient visit if the provider accepted the recommendation given by the PERK tool (i.e., a D-dimer was recommended and ordered or a CT pulmonary angiogram (CTPA) was recommended and ordered). This outcome measure is assessed using electronic health record (EHR) data from the patient visit.
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
1612 participants
Primary outcome timeframe
Up to Month 6
Results posted on
2023-06-26
Participant Flow
Participant milestones
| Measure |
Intervention Site - Providers
Providers at the site assigned to the intervention:
Full time employed Emergency Department providers will use the new CDS tool, Pulmonary Embolism Risk Kalculator (PERK), which includes nudges to improve use and will be integrated into the electronic medical record and will be accessible for 6 months
Pulmonary Embolism Risk Kalculator (PERK): Nudges are applications of behavioral science, defined as positive reinforcement and indirect suggestions that have a non-forced effect on decision making. Nudges will be to the PE CALC CDS tool to develop the new CDS tool, PERK.
|
No Intervention Site - Providers
Providers at the site assigned to no intervention:
Full time employed Emergency Department providers used a CDS tool, Pulmonary Embolism Calculator (PE CALC), without nudges to improve use, to reduce unnecessary imaging in the diagnosis of pulmonary embolism (PE) in the emergency department (ED).
|
Intervention Site - Patients
Patients at the site assigned to the intervention:
Full time employed Emergency Department providers will use the new CDS tool, Pulmonary Embolism Risk Kalculator (PERK), which includes nudges to improve use and will be integrated into the electronic medical record and will be accessible for 6 months
Pulmonary Embolism Risk Kalculator (PERK): Nudges are applications of behavioral science, defined as positive reinforcement and indirect suggestions that have a non-forced effect on decision making. Nudges will be to the PE CALC CDS tool to develop the new CDS tool, PERK.
|
No Intervention Site - Patients
Patients at the site assigned to no intervention:
Full time employed Emergency Department providers used a CDS tool, Pulmonary Embolism Calculator (PE CALC), without nudges to improve use, to reduce unnecessary imaging in the diagnosis of pulmonary embolism (PE) in the emergency department (ED).
|
|---|---|---|---|---|
|
Overall Study
STARTED
|
49
|
35
|
793
|
735
|
|
Overall Study
COMPLETED
|
49
|
35
|
793
|
735
|
|
Overall Study
NOT COMPLETED
|
0
|
0
|
0
|
0
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
Sex data were not collected from study participants.
Baseline characteristics by cohort
| Measure |
Intervention Site - Providers
n=49 Participants
Providers at the site assigned to the intervention:
Full time employed Emergency Department providers will use the new CDS tool, Pulmonary Embolism Risk Kalculator (PERK), which includes nudges to improve use and will be integrated into the electronic medical record and will be accessible for 6 months
Pulmonary Embolism Risk Kalculator (PERK): Nudges are applications of behavioral science, defined as positive reinforcement and indirect suggestions that have a non-forced effect on decision making. Nudges will be to the PE CALC CDS tool to develop the new CDS tool, PERK.
|
No Intervention Site - Providers
n=35 Participants
Providers at the site assigned to no intervention:
Full time employed Emergency Department providers used a CDS tool, Pulmonary Embolism Calculator (PE CALC), without nudges to improve use, to reduce unnecessary imaging in the diagnosis of pulmonary embolism (PE) in the emergency department (ED).
|
Intervention Site - Patients
n=793 Participants
Patients at the site assigned to the intervention:
Full time employed Emergency Department providers will use the new CDS tool, Pulmonary Embolism Risk Kalculator (PERK), which includes nudges to improve use and will be integrated into the electronic medical record and will be accessible for 6 months
Pulmonary Embolism Risk Kalculator (PERK): Nudges are applications of behavioral science, defined as positive reinforcement and indirect suggestions that have a non-forced effect on decision making. Nudges will be to the PE CALC CDS tool to develop the new CDS tool, PERK.
|
No Intervention Site - Patients
n=735 Participants
Patients at the site assigned to no intervention:
Full time employed Emergency Department providers used a CDS tool, Pulmonary Embolism Calculator (PE CALC), without nudges to improve use, to reduce unnecessary imaging in the diagnosis of pulmonary embolism (PE) in the emergency department (ED).
|
Total
n=1612 Participants
Total of all reporting groups
|
|---|---|---|---|---|---|
|
Age, Continuous
|
38 years
n=49 Participants
|
35 years
n=35 Participants
|
65 years
n=793 Participants
|
64 years
n=735 Participants
|
51 years
n=1612 Participants
|
|
Sex: Female, Male
Female
|
—
|
—
|
—
|
—
|
0 Participants
Sex data were not collected from study participants.
|
|
Sex: Female, Male
Male
|
—
|
—
|
—
|
—
|
0 Participants
Sex data were not collected from study participants.
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
—
|
—
|
69 Participants
n=793 Participants • Ethnicity data were not collected from Provider participants.
|
32 Participants
n=735 Participants • Ethnicity data were not collected from Provider participants.
|
101 Participants
n=1528 Participants • Ethnicity data were not collected from Provider participants.
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
—
|
—
|
673 Participants
n=793 Participants • Ethnicity data were not collected from Provider participants.
|
617 Participants
n=735 Participants • Ethnicity data were not collected from Provider participants.
|
1290 Participants
n=1528 Participants • Ethnicity data were not collected from Provider participants.
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
—
|
—
|
51 Participants
n=793 Participants • Ethnicity data were not collected from Provider participants.
|
86 Participants
n=735 Participants • Ethnicity data were not collected from Provider participants.
|
137 Participants
n=1528 Participants • Ethnicity data were not collected from Provider participants.
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
—
|
—
|
0 Participants
n=793 Participants • Race data were not collected from Provider participants.
|
0 Participants
n=735 Participants • Race data were not collected from Provider participants.
|
0 Participants
n=1528 Participants • Race data were not collected from Provider participants.
|
|
Race (NIH/OMB)
Asian
|
—
|
—
|
14 Participants
n=793 Participants • Race data were not collected from Provider participants.
|
32 Participants
n=735 Participants • Race data were not collected from Provider participants.
|
46 Participants
n=1528 Participants • Race data were not collected from Provider participants.
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
—
|
—
|
0 Participants
n=793 Participants • Race data were not collected from Provider participants.
|
0 Participants
n=735 Participants • Race data were not collected from Provider participants.
|
0 Participants
n=1528 Participants • Race data were not collected from Provider participants.
|
|
Race (NIH/OMB)
Black or African American
|
—
|
—
|
42 Participants
n=793 Participants • Race data were not collected from Provider participants.
|
435 Participants
n=735 Participants • Race data were not collected from Provider participants.
|
477 Participants
n=1528 Participants • Race data were not collected from Provider participants.
|
|
Race (NIH/OMB)
White
|
—
|
—
|
618 Participants
n=793 Participants • Race data were not collected from Provider participants.
|
146 Participants
n=735 Participants • Race data were not collected from Provider participants.
|
764 Participants
n=1528 Participants • Race data were not collected from Provider participants.
|
|
Race (NIH/OMB)
More than one race
|
—
|
—
|
0 Participants
n=793 Participants • Race data were not collected from Provider participants.
|
0 Participants
n=735 Participants • Race data were not collected from Provider participants.
|
0 Participants
n=1528 Participants • Race data were not collected from Provider participants.
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
—
|
—
|
119 Participants
n=793 Participants • Race data were not collected from Provider participants.
|
122 Participants
n=735 Participants • Race data were not collected from Provider participants.
|
241 Participants
n=1528 Participants • Race data were not collected from Provider participants.
|
|
Region of Enrollment
United States
|
49 Participants
n=49 Participants
|
35 Participants
n=35 Participants
|
793 Participants
n=793 Participants
|
735 Participants
n=735 Participants
|
1612 Participants
n=1612 Participants
|
PRIMARY outcome
Timeframe: Up to Month 6The tool is considered adopted during a patient visit if the provider accepted the recommendation given by the PERK tool (i.e., a D-dimer was recommended and ordered or a CT pulmonary angiogram (CTPA) was recommended and ordered). This outcome measure is assessed using electronic health record (EHR) data from the patient visit.
Outcome measures
| Measure |
Intervention Site - Patients and Providers
n=793 Patient Visits
Patients and Providers at the site assigned to the intervention:
Full time employed Emergency Department providers will use the new CDS tool, Pulmonary Embolism Risk Kalculator (PERK), which includes nudges to improve use and will be integrated into the electronic medical record and will be accessible for 6 months
Pulmonary Embolism Risk Kalculator (PERK): Nudges are applications of behavioral science, defined as positive reinforcement and indirect suggestions that have a non-forced effect on decision making. Nudges will be to the PE CALC CDS tool to develop the new CDS tool, PERK.
|
No Intervention Site - Patients and Providers
n=735 Patient Visits
Patients and Providers at the site assigned to no intervention:
Full time employed Emergency Department providers used a CDS tool, Pulmonary Embolism Calculator (PE CALC), without nudges to improve use, to reduce unnecessary imaging in the diagnosis of pulmonary embolism (PE) in the emergency department (ED).
|
|---|---|---|
|
Percentage of Patient Visits Where the Provider Adopted the Pulmonary Embolism Risk Kalculator (PERK) Tool
|
39.11 Percentage of Patient Visits
|
20.66 Percentage of Patient Visits
|
SECONDARY outcome
Timeframe: Up to Month 6Monitored using EHR reporting data. Calculated as the percentage of CTPA tests ordered to evaluate for PE that are positive for PE.
Outcome measures
| Measure |
Intervention Site - Patients and Providers
n=707 PE-Designated CTPA Tests
Patients and Providers at the site assigned to the intervention:
Full time employed Emergency Department providers will use the new CDS tool, Pulmonary Embolism Risk Kalculator (PERK), which includes nudges to improve use and will be integrated into the electronic medical record and will be accessible for 6 months
Pulmonary Embolism Risk Kalculator (PERK): Nudges are applications of behavioral science, defined as positive reinforcement and indirect suggestions that have a non-forced effect on decision making. Nudges will be to the PE CALC CDS tool to develop the new CDS tool, PERK.
|
No Intervention Site - Patients and Providers
n=641 PE-Designated CTPA Tests
Patients and Providers at the site assigned to no intervention:
Full time employed Emergency Department providers used a CDS tool, Pulmonary Embolism Calculator (PE CALC), without nudges to improve use, to reduce unnecessary imaging in the diagnosis of pulmonary embolism (PE) in the emergency department (ED).
|
|---|---|---|
|
Percentage of PE-Designated CTPA Tests That Are Positive for PE
|
26.45 Percentage of PE-Designated CTPA Tests
|
10.76 Percentage of PE-Designated CTPA Tests
|
Adverse Events
Intervention Site - Patients
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
No Intervention Site - Patients
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place