The RAD-HOME Project: a Pilot Study of Domiciliary Teleradiology

Study Overview
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Brief Summary
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Aim of the study is to assess feasibility and safety of a public territorial radiology service for home hospitalized frail elderly patients whose health conditions discourage the transportation to hospital.

Official Title
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The RAD-HOME Project: a Randomized Pilot Study of a Domiciliary Teleradiology Program for Frail Elderly Patients

Conditions
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Acute Congestive Heart Failure, Exacerbation of COPD, Pneumonia, Fractures, Osteomyelitis

Intervention / Treatment
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* Radiation: Home X-rays
* Radiation: X-rays in hospital


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: immobilization or chairbound, need for chest, pelvis/hips, joints, upper and lower limbs, hands and feet X-rays, absence of definite delirium at enrollment according to the Confusion Assessment Method, and intermediate or high risk of delirium according to the criteria of Inouye. Exclusion Criteria: need of urgent examination (within 24 hours), need of X-ray examinations not suitable at home.

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

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: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: X-rays at home<br>Home hospitalized elderly patients undergo X-rays at home | Radiation: Home X-rays<br>* X-rays examinations performed at home<br>|
| Active Comparator: Hospital X-rays<br>Home hospitalized elderly patients undergo X-rays examinations in hospital | Radiation: X-rays in hospital<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison of episodes of delirium related to the radiological procedure at home and in hospital, using the Confusion Assessment Method (CAM) | Frail patients, especially old ones,often develop delirium or confusion when moved from their usual environment. In home-hospitalized patients with the same risk of developing delirium, according to the Inouye's criteria, we evaluated the onset of a confusional status after X-rays performed at home or in hospital | 24 hours after the radiological procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluation of direct and indirect costs of the radiological procedures performed at home or in hospital | Evaluation of costs includes: costs for transportation, ambulance, equipment (eg, processing costs), materials (eg, CD), technical staff (eg, radiographers, radiologists); for the control group: costs for working time employed by family members and health staff to bring patients to hospital for X.ray examination | 1 year | 
| Satisfaction of patients and/or families | Customer satisfaction is evaluated using an ad hoc questionnaire | within 1 month after the procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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hospital at home, radiology at home, frail elderly