Natural Language Processing and Quality Assessment in Primary Care

Study Overview
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Brief Summary
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The investigators propose to use a Natural Language Processing System (NLP) to provide an initial baseline report for primary care patients at risk for diabetes and cardiovascular complications that will include: a) evidence of foot exam documentation in the previous year; b) use of aspirin for cardiovascular risk reduction; and c) tobacco use. As part of a randomized trial, we plan to use a previously validated mailed survey (NCQA Provider Recognition Program) that requests information on the last foot exam, use of aspirin and tobacco. Patients who have been identified by NLP as not having had a foot exam will be randomized into treatment and control arms. Both arms will receive an informational letter; with a second mailing to nonresponders after one month, describing the key strategies for effective patient-physician communication during the clinical encounter. The treatment arm will also receive an informational letter and patient education brochure containing key messages about the importance of regular foot examinations. NLP will be repeated after 6 months to compare the impact of the patient education materials.

Official Title
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Novel Use of Natural Language Processing and Targeted Patient Education Information Regarding the Process for Completion of the Foot Examination in Primary Care

Conditions
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Diabetes

Intervention / Treatment
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* Other: Brochure: Care of the Feet for Those at Risk
* Other: Quality Survey: foot exam, tobacco and aspirin use


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: primary care patients with diagnosis of diabetes Exclusion Criteria: unwilling to give informed consent
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: 1 CAre of the Feet for Those at Risk<br>secular trends for physician documentation in the medical record for care of the feet for high risk patients | Other: Brochure: Care of the Feet for Those at Risk<br>* Patient education materials and key messages for care of the feet for those patients at risk<br>* Other names: Care of the Feet For Those at Risk;Other: Quality Survey: foot exam, tobacco and aspirin use<br>* NCQA Patient Survey<br>* Other names: Care of the Feet For Those at Risk;|
| Active Comparator: Care of the feet for those at risk<br>the impact of 1) patient survey regarding last foot exam, tobacco and aspirin use on documentation of foot exam and 2) patient education material: Care of the Foot For Those at Risk, on documentation of foot examination in the medical record | Other: Quality Survey: foot exam, tobacco and aspirin use<br>* NCQA Patient Survey<br>* Other names: Care of the Feet For Those at Risk;|
| Active Comparator: Impact of Quality Survey<br>Impact of patient survey regarding last foot exam, tobacco and aspirin use on documentation of foot exam in the medical record | Other: Brochure: Care of the Feet for Those at Risk<br>* Patient education materials and key messages for care of the feet for those patients at risk<br>* Other names: Care of the Feet For Those at Risk;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Completion of foot exam |  | 6 months post intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient report in validation of Natural Language Processing |  | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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foot exam, health services, practice improvement, quality, preventive services, Natural Language Processing