- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05322694
Clinical Decision Rules in the Emergency Department to Improve the Management of Acute Respiratory Infection and Acute Infectious Diarrhea
Multicenter Prospective Cohort Study to Derive and Validate Clinical Decision Rules in Emergency Department Triage to Improve the Care Pathway for Patients With Acute Respiratory Infection or Acute Infectious Diarrhea.
Study Overview
Status
Study Type
Enrollment (Actual)
Contacts and Locations
Study Contact
- Name: Simon Berthelot, MD MSc FRCPC
- Phone Number: 70553 418-525-4444
- Email: simon.berthelot@fmed.ulaval.ca
Study Locations
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-
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Québec, Canada, G1V 4G2
- CHU de Québec - Université Laval
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Quebec
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Montréal, Quebec, Canada, H2X 0A9
- Centre Hospitalier Universitaire de Montréal
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Montréal, Quebec, Canada, H3T 1E2
- Hôpital Général Juif
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Acute Respiratory Infections :
Inclusion Criteria:
- 18 years of age or older;
- Able to consent to the study;
- Reachable by phone;
- Consent to be reached directly by phone;
- At least one of the following respiratory symptoms consistent with an acute respiratory infection for 10 days or less, i. Cough and/or ii. Purulent sputum and/or iii. Pharyngeal pain and/or iv. Nasal congestion and/or v. Rhinorrhea and/or vi. Agueusia and/or vii. Anosmia;
- A triage score of 3 (30 minutes), 4 (60 minutes) or 5 (120 minutes) on the Canadian Triage and Acuity Scale (CTAS);
- Triaged by the ED nurse and managed according to standard ED care protocols;
- Resident of Québec;
- Holder of a Québec health insurance number.
Exclusion Criteria:
- Cognitive impairment that prevents the patient from reliably answering the risk stratification tool or research questions;
- Resident of a long-term care facility;
- Refusal of nasopharyngeal swab.
Acute infectious diarrhea :
Inclusion Criteria:
- 18 years of age or older;
- Able to consent to the study;
- Reachable by phone;
- Consent to be reached directly by phone;
- At least three loose or liquid stools over a 24-hour period and for 10 days or less;
- A triage score of 3 (30 minutes), 4 (60 minutes) or 5 (120 minutes) on the Canadian Triage and Acuity Scale (CTAS);
- Triaged by the ED nurse and managed according to standard ED care protocols;
- Resident of Québec.
- Holder of a Québec health insurance number.
Exclusion Criteria:
- Known neutropenia (<500 neutrophils);
- Active inflammatory bowel disease;
- Anorectal pathology;
- Recent colonic surgery (< 6 months);
- Cognitive impairment preventing the patient from reliably answering the risk stratification tool or research questions;
- Resident of a long-term care facility;
- Refusal of the rectal swab.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
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Acute respiratory infections
Participants will be recruited according to their symptoms when presenting to the emergency room. They can be included either in the acute respiratory infection group or acute infectious diarrhea group or both. Immediately after triage, eligible patients will be approached by research personnel (nurse or other professional authorized to perform the sampling and techniques required for the study) and enrolled after consent has been obtained. Once the study procedures are completed, participants will follow the care pathway that they would normally follow without the research project. The results of the clinical decision rule (molecular test and risk stratification tool) will not be disclosed to the treating team or the patient. |
Acute infectious diarrhea
Participants will be recruited according to their symptoms when presenting to the emergency room. They can be included either in the acute respiratory infection group or acute infectious diarrhea group or both. Immediately after triage, eligible patients will be approached by research personnel (nurse or other professional authorized to perform the sampling and techniques required for the study) and enrolled after consent has been obtained. Once the study procedures are completed, participants will follow the care pathway that they would normally follow without the research project. The results of the clinical decision rule (molecular test and risk stratification tool) will not be disclosed to the treating team or the patient. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
7- and 30-day combined incidence of ED returns, hospitalizations, and deaths.
Time Frame: 30 days
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Combined proportion incidence at 7 and 30 days after the initial visit of ED returns, hospitalizations and deaths related to acute respiratory infection or acute infectious diarrhea (obtained from provincial administrative databases).
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30 days
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence proportion of ED returns
Time Frame: 30 days
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Incidence proportion of ED returns at 7 and 30 days after the initial visit.
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30 days
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Incidence of prescribing antiviral medication
Time Frame: 7 days
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Incidence of prescribing antiviral medication (e.g., oseltamivir) at the initial ED visit and at 7 days (telephone follow-up).
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7 days
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Incidence of antibiotic prescribing
Time Frame: 7 days
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Incidence of antibiotic prescribing at initial visit and at 7 days (telephone follow-up).
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7 days
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Incidence of intensive care unit admission
Time Frame: 30 days
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Incidence of intensive care unit admission at 30 days (obtained from provincial administrative database on hospital admissions).
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30 days
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Mean costs of care of the initial ED visit from a health system perspective
Time Frame: 30 days
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Mean costs of the initial ED visit from a health system perspective estimated using time-driven activity-based costing (data obtained from initial visit data collection, electronic medical records and provincial physician billing database).
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30 days
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Mean costs of the disease from the patient perspective
Time Frame: 7 days
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Mean 7-day costs from the patient perspective (obtained from the Cost for Patient Questionnaire - the CoPaQ- administered at telephone follow-up).
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7 days
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Length of stay in the ED
Time Frame: Measured from ED arrival to ED discharge on the initial visit (maximum 120 hours)
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Length of stay in the ED on the initial visit (electronic medical records).
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Measured from ED arrival to ED discharge on the initial visit (maximum 120 hours)
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Incidence proportion of hospitalizations
Time Frame: 30 days
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Incidence proportion of hospitalizations at 7 and 30 days after the initial visit.
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30 days
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Incidence proportion of deaths
Time Frame: 30 days
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Incidence proportion of deaths at 7 and 30 days after the initial visit.
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30 days
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- FACS
- CRI-2021-02 (Other Identifier: CHU de Québec - Université Laval)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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