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Education and Feedback Intervention to Reduce Inappropriate Transthoracic Echocardiograms

10. februar 2014 opdateret af: Rory Weiner, MD, Massachusetts General Hospital

Educational Intervention to Reduce Outpatient Inappropriate Transthoracic Echocardiograms Ordered by Attending Physicians

The utilization of transthoracic echocardiography in the United States has been increasing. This has resulted in increased costs to the healthcare system. In an effort to curb excessive utilization of this technology, the American College of Cardiology created Appropriate Use Criteria to help guide clinicians to use this diagnostic imaging modality more appropriately. The investigators previously showed that an educational intervention can reduce the rate of inappropriate echocardiograms ordered by physicians-in-training. It is unknown if such an intervention would be successful in attending, staff level of physicians. The investigators hypothesize that an educational and feedback intervention will reduce the rate of inappropriate outpatient transthoracic echocardiograms ordered by staff cardiologists and internal medicine physicians.

Studieoversigt

Status

Ukendt

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

In response to increasing utilization of echocardiography, the American Society of Echocardiography along with the American College of Cardiology released Appropriate Use Criteria (AUC) for transthoracic echocardiography (TTE) in 2007, and these have been subsequently updated in 2011. TTE ordering patterns have been evaluated and have shown that between 15-30% of TTE ordered are inappropriate. The highest rate of inappropriate TTE is found in the outpatient environment, where routine or "surveillance" studies are common. These studies have also found that internists and cardiologists order the majority of TTE. The investigators previously documented that an AUC-based educational and feedback intervention reduced the rate of inappropriate TTE by cardiology and internal medicine physicians-in-training. Whether this type of intervention can improve TTE ordering of attending level physicians is not known.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

150

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02114
        • Rekruttering
        • Massachusetts General Hospital
        • Kontakt:
        • Ledende efterforsker:
          • Rory B Weiner, MD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Barn
  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Cardiology Attending physicians at Massachusetts General Hospital
  • Primary care physicians at Massachusetts General Hospital

Exclusion Criteria:

  • Physicians-in-training

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Sundhedstjenesteforskning
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Educational Intervention
Attending physicians in the intervention arm will receive the following multi-faceted educational intervention on transthoracic echocardiogram appropriateness: 1) a lecture at the beginning of the study period, which describes Appropriate USe Criteria (AUC) and highlights common clinical scenarios for which outpatient echocardiograms are ordered, 2) an electronic "pocket cared" via email that provides tips on appropriate ordering of echocardiograms, and 3) an individualized monthly feedback report that categorizes echocardiograms ordered over the preceding month. The feedback report will contain the number of echocardiograms ordered during the month and how many are classified as appropriate, inappropriate, or uncertain based on the 2011 AUC.
Adfærdsmæssigt: Educational Intervention
Ingen indgriben: Control Group
Attending physicians in the control arm will have their echocardiogram orders tracked and classified, but will not receive any feedback on their ordering behavior.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Rate of Inappropriate transthoracic echocardiograms
Tidsramme: 12 months
Rate of inappropriate echocardiograms determined from a review of the electronic medical record.
12 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Rate of Appropriate transthoracic echocardiograms
Tidsramme: 12 months
Rate of appropriate transthoracic echocardiograms determined from a review of the electronic medical record.
12 months

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Clinical reasons for appropriate and inappropriate transthoracic echocardiograms
Tidsramme: 12 months
All echocardiograms will be classified according to the Appropriate Use Criteria (AUC). This will allow for determination of the most common clinical indications for both appropriate and inappropriate echocardiograms.
12 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Massachusetts General Hospital

Efterforskere

  • Ledende efterforsker: Rory B Weiner, MD, Massachusetts General Hospital

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. november 2013

Primær færdiggørelse (Forventet)

1. oktober 2014

Studieafslutning (Forventet)

1. oktober 2014

Datoer for studieregistrering

Først indsendt

20. oktober 2013

Først indsendt, der opfyldte QC-kriterier

20. oktober 2013

Først opslået (Skøn)

24. oktober 2013

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

11. februar 2014

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

10. februar 2014

Sidst verificeret

1. februar 2014

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • 2011P001779 AME3

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Educational Intervention

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Macedonia

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

Abonner