Radiographic Contrast Agent Nephropathy
Conditions
Keywords
Clinical Decision Support Systems, Contrast-induced nephropathy
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.
Interventions
OTHERPatient-specific computerized reminder
The intervention targets are physicians,not patients. This CDSS alerts physicians only when the patient with high risk of contrast-induced-nephropathy(CIN) is encountered. On the contrast, the CDSS will not alert when the patient without CIN risk is encountered.
OTHERNon-patient-specific computerized reminder
The non-patient-specific computerized reminder always pops up to remind physicians to check their patient's CIN risk no matter what CIN risk is.
Sponsors
National Science and Technology Council, Taiwan
Taipei Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
25 Years to 70 Years
Healthy volunteers
Yes
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The percentage of contrast-enhanced imaging(CEI) orders with high CIN risk | Physicains who participated in this trial will be followed for an expected average of 12 months | The number of CEI ordered for patients at high CIN risk, divided by the total number of CEI orders. \[CEI\]: contrast-enhanced image studies,such as CT or IVU. \[CIN\]: contrast-induced nephropathy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The order elimination rate of high CIN risk orders attributed to the computerized reminder | Physicains who participated in this trial will be followed for an expected average of 12 months | The number of CEI orders with high CIN risk cancelled by the physician attributed to our computerized reminder, divided by the total number of CEI orders with high CIN risk. |
Countries
Taiwan
Outcome results
None listed