Clinical Practice Guidelines Versus Decision-support for Latent Tuberculosis Infection (LTBI) Management

Study Overview
=================
Brief Summary
-----------------
Latent Tuberculosis infection (LTBI) guidelines can be complex. LTBI-ASSIST is a web-based interactive tool to navigate US LTBI clinical practice guidelines in a patient-centered format that may guide clinical decision making around Latent TB care. The research goal is to determine the difference in reported confidence among trainees that are not experts in LTBI care. The investigators further aim to assess if access to the LTBI-ASSIST tool improves clinical decision making in a series of simulated case scenarios containing guideline-derived, multiple choice items, as well as assess the efficiency in navigating the scenarios - measured by time to complete the survey. The investigators proposed a randomized study design, in which an electronic survey/questionnaire with 4 case scenarios consisting of 14 multiple choice questions. Participants providing informed consent will be randomized to receiving access to either US Centers for Disease Control (CDC)/National Tuberculosis (TB) Controllers Association (NTCA) Guidelines or the LTBI-ASSIST online tool. Those in the experimental arm will further complete a 10 question System Usability Scale to assess usability of the LTBI-ASSIST tool. All Johns Hopkins medical trainees and residents will be eligible to participate.

Official Title
-----------------
Evaluation of Clinical Practice Guidelines and Educational Decision-support Tools on Medical Trainees' Confidence With Latent Tuberculosis (LTBI) Testing and Treatment: A Randomized Trial

Conditions
-----------------
Latent Tuberculosis

Intervention / Treatment
-----------------
* Behavioral: CDC/NTCA guidelines only
* Behavioral: LTBI ASSIST and CDC/NTCA guidelines only


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Student at Johns Hopkins School of Medicine, or Medical trainee at Hopkins Hospital or Bayview Program Exclusion Criteria: None

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: CDC/NTCA guidelines only<br>The control group will have a link to US guidelines only and use it as a resource to answer the case vignettes. | Behavioral: CDC/NTCA guidelines only<br>* The control group will have a link to US guidelines only.<br>|
| Experimental: LTBI ASSIST and CDC/NTCA guidelines<br>The intervention group will have a link to both US guidelines, and the LTBI-ASSIST tool as resources to answer the case vignettes. | Behavioral: LTBI ASSIST and CDC/NTCA guidelines only<br>* The intervention group will have a link to both US guidelines, and the LTBI-ASSIST tool.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reported confidence with LTBI management [using a Likert scale questionnaire developed by study team] | The primary outcome will be the change in reported confidence with LTBI management, comparing between the control and intervention group. This outcome will be measured using a Likert Scale questionnaire administered pre- and post-intervention asking trainees to rate their confidence in performing critical LTBI care proficiencies. | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of appropriate LTBI care selection | The number of multiple choice questions answered correctly in the case scenarios comparing between trainees and/or CDC/NTCA guidelines. | 3 months | 
| Time to LTBI care selection | The time required for each group to reach a correct answer. | 3 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Tuberculosis, Education