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

Taipei Medical University

Status: Unknown

Conditions: Radiographic Contrast Agent Nephropathy

Treatments: Other: Non-patient-specific computerized reminder; Other: Patient-specific computerized reminder

Study type: Interventional

Funder types: Other

Identifiers

NCT01778140

NSC100-2320-B-038-034

Details and patient eligibility

About

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.

Full 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.

Enrollment: 90 estimated patients

Sex: All

Ages: 25 to 70 years old

Volunteers: Accepts Healthy Volunteers

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

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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90 participants in 3 patient groups

Patient-specific reminder

Experimental group

Description:

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.

Treatment:

Other: Patient-specific computerized reminder

Non-patient-specific reminder

Active Comparator group

Description:

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.

Treatment:

Other: Non-patient-specific computerized reminder

Control Arm

No Intervention group

Description:

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