Cough, Dyspnea
Conditions
Keywords
respiratory complaints, dyspnea, cough, checklist
Brief summary
This is a randomized clinical trial that evaluates the impact of using an internet-based checklist for systematic assessment of patients reporting respiratory complaints with the conventional assessment, without using the checklist.
Detailed description
This is a randomized clinical trial that evaluates the impact of using an internet-based checklist for systematic assessment of patients reporting respiratory complaints with the conventional assessment, without using the checklist. Study setting: emergency department related acute evaluation outpatient clinic Inclusion criteria: 18 years of age or older; patients presenting to the ED reporting cough or dyspnea; Exclusion criteria: acute respiratory failure; SpO2 \< 92%; any signs of hemodynamic or respiratory instability; possible concurrent diagnosis requiring immediate assessment (e.g..: acute coronary syndrome or stroke; ) Primary outcome: need of reassessment in the ED or hospitalization within 1 month of index evaluation (intervention). Secondary outcomes: number of complete blood counts ordered in the index evaluation; number of other diagnostic tests ordered in the index evaluation; Randomization: block 1:1; stratified by gender and age (\>50 years old). Masking will be appllied to: patients; outcome assessors; data analysts;
Interventions
OTHERChecklist
3 page checklist with suggestions of possible diagnosis according to clinical presentation of patients presenting with dyspnea or cough; also suggests diagnostic tests that are likely to be useful in each situation.
OTHERConventional evaluation
Physician evaluation without the use of checklists
Sponsors
Hospital de Clinicas de Porto Alegre
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
18 years of age or older; patients presenting to the ED reporting cough or dyspnea; legally capable.
Exclusion criteria
acute respiratory failure; SpO2 \< 92%; any signs of hemodynamic or respiratory instability; possible concurrent diagnosis requiring immediate assessment (e.g..: acute coronary syndrome or stroke; )
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Need to visit the emergency department or acute evaluation outpatient clinic | 1 month |
| Complete blood count ordered in the index evaluation | 1 month |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of diagnostic tests ordered in the index evaluation | 1 month | — |
| Hospital admission | 1 month | — |
| Antibiotics prescription | 1 month | Frequency and type of antibiotic prescribed in each study arm |
| Major events | 1 month | Composite endpoint: revisit to emergency department OR hospital admission OR death |
Countries
Brazil
Outcome results
None listed