Clinical trial NCT01778140: Comparing Effects of Patient-specific Versus Non-patient-specific Computerized Reminder System
Official title: Randomized Controlled Trial: Comparing Effects of Patient-Specific Versus Non-Patient-Specific Computerized Reminder System to Reduce Contrast-Induced Nephropathy
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Radiographic Contrast Agent Nephropathy
Keywords: Clinical Decision Support Systems
Contrast-induced nephropathy
Lead sponsor: Taipei Medical University
Sponsor class: OTHER
Collaborators: name: National Science and Technology Council, Taiwan
First posted: 2013-01-29
Enrollment: 90
Sex: ALL
Minimum age (years): 25
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: 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.

Detailed 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.

Eligibility criteria: 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

Primary outcomes:
measure: The percentage of contrast-enhanced imaging(CEI) orders with high CIN risk
timeFrame: Physicains who participated in this trial will be followed for an expected average of 12 months
Secondary outcomes:
measure: The order elimination rate of high CIN risk orders attributed to the computerized reminder
timeFrame: Physicains who participated in this trial will be followed for an expected average of 12 months
Other outcomes:
Locations:
city: Taipei
country: Taiwan
facility: Taipei medical university hospital
Study officials:
affiliation: Taipei Medical University
name: Yu-Chuan Li
role: PRINCIPAL_INVESTIGATOR
References: