Nudging Provider Adoption of Clinical Decision Support: Implementation of an EHR-Agnostic Pulmonary Embolism Risk Prediction Tool

January 21, 2026 updated by: NYU Langone Health
The purpose of this study is to examine the impact of the nudge implementation strategy (CDS tool + Nudge) on adoption of guideline-concordant CT ordering for pulmonary embolism (PE) in 10 EDs. The study will be a 33-month, rigorous, pragmatic, cluster-randomized, stepped wedge trial across 3 health systems and 10 EDs after collecting pre-implementation baseline data. The aim is to to demonstrate technological feasibility as well as examine efficacy of the nudges on adoption. The secondary objective is to decrease CT-ordering when it is not indicated.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Part 1 of the study included the collection of data. During the pre-implementation period each sites electronic health record (EHR) and baseline data was collected for 12 months. In Part 2, the study will examine the impact of the nudge implementation strategy (CDS tool + Nudge) on adoption of guideline-concordant CT ordering for PE in 10 EDs. Adoption outcomes data will be collected through EHR reporting systems.

Study Type

Interventional

Enrollment (Estimated)

440

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 Contact

Study Contact Backup

Study Locations

  • United States
    • New York
      • Manhasset, New York, United States, 11030
        • Northwell Health - Feinstein Institute for Medical Research
      • New York, New York, United States, 10016
        • NYU Langone Health
    • Texas
      • Houston, Texas, United States, 77030
        • Baylor College of Medicine

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  1. 18 years of older
  2. A provider (MD, NP, PA) ordering CTs for evaluation of PE in adult patients present at study site Emergency Department (i.e., Northwell Health - Feinstein Institute for Medical Research, Baylor College of Medicine and NYU Langone Health).

Exclusion Criteria:

1. A provider not present at the specified study sites.

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: Supportive Care
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Emergency Department (ED) Providers
Each ED will serve as its own control. Baseline data will be collected for 12 months prior to the implementation of the CDS system with nudges. The CDS tool with nudges will then be implemented for 33 months.
Behavioral: Clinical Decision Support (CDS) tool with Nudges
The CDS tool with nudges provide information to providers to practice medicine in accordance with CT (computed tomography) ordering guidelines. The tool will only deploy when the provider is going against clinical guidelines and therefore provides a chance for the provider to reconsider their actions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of CT scan orders that are guideline-concordant
Time Frame: Baseline (Month 12)
Guideline-concordant is defined as CT scan orders with Wells' Score >4 ["PE Likely"] and/or d-dimer above upper limit of normal.
Baseline (Month 12)
Percentage of CT scan orders that are guideline-concordant
Time Frame: End of intervention (Month 45)
Guideline-concordant is defined as CT scan orders with Wells' Score >4 ["PE Likely"] and/or d-dimer above upper limit of normal.
End of intervention (Month 45)

Collaborators and Investigators

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

Sponsor

NYU Langone Health

Collaborators

National Heart, Lung, and Blood Institute (NHLBI)

Investigators

  • Principal Investigator: Safiya Richardson, MD MPH, NYU Langone Health

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 (Estimated)

February 15, 2026

Primary Completion (Estimated)

July 1, 2028

Study Completion (Estimated)

March 31, 2029

Study Registration Dates

First Submitted

November 18, 2025

First Submitted That Met QC Criteria

November 18, 2025

First Posted (Actual)

November 25, 2025

Study Record Updates

Last Update Posted (Actual)

January 22, 2026

Last Update Submitted That Met QC Criteria

January 21, 2026

Last Verified

November 1, 2025

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 23-01528
  • 5R01HL169364-02 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The de-identified participant data from the final research dataset will be shared upon reasonable request beginning 9 to 36 months after publication or as required by a condition of awards or supporting agreements, provided the requesting investigator executes a data use agreement with NYU Langone Health. This instance of data sharing will also require separate IRB review as well as review from NYU Langone's Data Sharing Strategy Board (DSSB). Requests should be directed to: Safiya.richardson@nyulangone.org. The protocol and statistical analysis plan will be posted on Clinicaltrials.gov only as required by federal regulation or supporting awards and agreements.

IPD Sharing Time Frame

Beginning 9 months and ending 36 months following article publication or as required by a condition of awards and agreements supporting the research.

IPD Sharing Access Criteria

The investigator who proposed to use the data will be granted access upon reasonable request. Requests should be directed to Safiya.richardson@nyulangone.org. To gain access, data requestors will need to sign a data access agreement. This instance of data sharing will also require separate IRB review as well as review from NYU Langone's DSSB.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP

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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