CT C-spine Audit and Feedback

November 6, 2023 updated by: Karl Chamberlin, University of Massachusetts, Worcester

Audit and Feedback for Computed Tomography of the Cervical Spine in the Emergency Department

This is a prospective quality improvement study to assess the effect of using an audit-and-feedback process for emergency providers on utilization of computed tomography of the cervical spine. The objective of this study is to determine whether providing repeated individualized feedback on CT C-spine utilization to emergency providers alters their practice pattern and reduces overutilization. The investigators hypothesize that emergency providers who receive individualized feedback regarding their CT C-spine utilization on a regular basis will alter their practice pattern to reduce overutilization of this imaging study.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

80

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Massachusetts
      • Worcester, Massachusetts, United States, 01655
        • University of Massachusetts Chan Medical School

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Emergency medicine physician, nurse practitioner, or physician assistant
  • Ordered at least 5 CT scans of the cervical spine on adult patients in the two-month pre-intervention period

Exclusion Criteria:

  • Non-emergency providers
  • Ordered few than 5 studies in the pre-intervention period

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Serial In-Person Feedback
Providers are given recurring individualized in-person feedback on their practice patterns.
Behavioral: Audit and Feedback on Individual Practice Patterns
Providers are given feedback on their practice patterns of ordering computed tomography of the cervical spine.
Experimental: In-Person Feedback with Serial Electronic Feedback
Providers are given one-time individualized in-person feedback on their practice patterns, followed by recurrent individualized electronic feedback.
Behavioral: Audit and Feedback on Individual Practice Patterns
Providers are given feedback on their practice patterns of ordering computed tomography of the cervical spine.
No Intervention: Control
Providers are not given any feedback on their practice patterns.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percent NEXUS-Negative
Time Frame: 6 months
Percentage of CT C-spine studies that an individual provider ordered on NEXUS-negative patients
6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Fractures
Time Frame: 6 months
Number of cervical spine fractures identified on CT for patients who are NEXUS-negative
6 months
Clinically Significant Fractures
Time Frame: 6 months
Number of cervical spine fractures identified on CT for patients who are NEXUS-negative that required procedural intervention, hospitalization, or prolonged immobilization
6 months
Number of CTs
Time Frame: 6 months
Number of CT scans of the cervical spine ordered by each provider
6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Massachusetts, Worcester

Investigators

  • Principal Investigator: Karl T Chamberlin, MD, University of Massachusetts Chan Medical School

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2023

Primary Completion (Actual)

October 31, 2023

Study Completion (Actual)

October 31, 2023

Study Registration Dates

First Submitted

January 24, 2023

First Submitted That Met QC Criteria

January 24, 2023

First Posted (Actual)

February 2, 2023

Study Record Updates

Last Update Posted (Actual)

November 9, 2023

Last Update Submitted That Met QC Criteria

November 6, 2023

Last Verified

November 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • STUDY00000533

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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