- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT07685145
Clinical Decision Support System for Early Mobilization in the Neuro-ICU (CDSS-EM-ICU)
Implementation and Feasibility of a Clinical Decision Support System for Early Mobilization in the Intensive Care Unit
This study aims to evaluate the feasibility, safety, and user acceptability of a tablet- and smartphone-based Clinical Decision Support System (CDSS) designed to guide early mobilization for patients with severe neurological conditions in the intensive care unit (ICU). The CDSS standardizes safety screening across neurological, physiological, and device-related domains and provides graded mobility recommendations from Level 0 (passive range of motion) to Level 10 (independent ambulation).
The single-center, single-arm feasibility study will be conducted over six months in neurosurgical and trauma ICUs. Adult patients (≥18 years) with traumatic brain injury, intracerebral hemorrhage, subarachnoid hemorrhage, or acute ischemic stroke will be included. Primary outcomes include protocol adherence, data completeness, and user satisfaction (System Usability Scale). Secondary outcomes include time to first mobilization, maximum mobility level achieved, and adverse event incidence.
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Tipo di studio
Iscrizione (Effettivo)
Fase
- Non applicabile
Contatti e Sedi
Luoghi di studio
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Taipei, Taiwan
- National Taiwan University Hospital (NTUH)
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Adults (≥18 years) admitted to the neuro-ICU or trauma ICU.
- Diagnosis of acute neurological conditions, including traumatic brain injury (TBI), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), or acute ischemic stroke (AIS).
- Hemodynamically stable and deemed eligible for rehabilitation evaluation.
- Expected ICU stay ≥48 hours.
Exclusion Criteria:
- Pre-existing severe physical disability (modified Rankin Scale ≥4 before admission).
- Unstable intracranial pressure or craniectomy with active cerebrospinal fluid leakage.
- Unstable fractures or contraindications for mobilization as determined by the attending physician.
- Palliative care status or do-not-resuscitate (DNR) orders.
- Patients unable to participate in mobilization assessment due to medical instability or family refusal.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Ricerca sui servizi sanitari
- Assegnazione: N / A
- Modello interventistico: Assegnazione di gruppo singolo
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
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Sperimentale: CDSS-Guided Early Mobilization
The CDSS is a tablet- and smartphone-based system designed to standardize safety screening and guide early mobilization decisions for neuro-ICU patients.
It provides graded mobility level recommendations based on neurological, physiological, and device-related parameters
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The CDSS is a tablet- and smartphone-based system designed to standardize safety screening and guide early mobilization decisions for neuro-ICU patients.
It provides graded mobility level recommendations based on neurological, physiological, and device-related parameters.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Protocol Adherence Rate
Lasso di tempo: From ICU admission to ICU discharge (approximately up to 30 days).
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The proportion of ICU patient-days in which the mobilization activity executed by the therapist matches the mobility level recommended by the Clinical Decision Support System (CDSS).
An adherence rate of ≥80% will be considered acceptable implementation fidelity.
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From ICU admission to ICU discharge (approximately up to 30 days).
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Data Completeness Rate
Lasso di tempo: Throughout the 6-month study implementation period.
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The proportion of required data fields accurately completed within the CDSS interface.
A data completeness rate of ≥90% will indicate adequate system usability and workflow compliance.
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Throughout the 6-month study implementation period.
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User Acceptability (System Usability Scale Score)
Lasso di tempo: Assessed at the end of the 6-month study period.
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The mean System Usability Scale (SUS) score obtained from ICU clinicians after using the CDSS for at least 4 weeks.
A mean score ≥70 will be considered satisfactory usability.
The System Usability Scale (SUS) is a validated 10-item questionnaire with scores ranging from 0 to 100.
Higher scores indicate better usability and greater user acceptability.
A score of 70 or above is generally considered acceptable usability.
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Assessed at the end of the 6-month study period.
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Time to First Mobilization at Level ≥2
Lasso di tempo: From ICU admission until the first mobilization (up to 30 days).
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The number of days from ICU admission to the first mobilization episode reaching Level 2 or higher (e.g., edge-of-bed sitting or above) as determined by the CDSS mobility scale.
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From ICU admission until the first mobilization (up to 30 days).
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Highest Mobility Level Achieved by Day 5
Lasso di tempo: First 5 days after ICU admission.
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The maximum mobility level achieved by each participant within the first three ICU days, based on the modified 0-10 ICU Mobility Scale recorded through the CDSS.
Modified ICU Mobility Scale (0-10) ranges from 0 to 10, with higher scores indicating greater mobility and functional independence.
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First 5 days after ICU admission.
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Highest Mobility Level at ICU Discharge
Lasso di tempo: From ICU admission to ICU discharge (approximately up to 30 days).
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The highest mobility level reached before ICU discharge, as recorded by the CDSS daily log.
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From ICU admission to ICU discharge (approximately up to 30 days).
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Incidence of Mobilization-Related Adverse Events
Lasso di tempo: From the first mobilization session until ICU discharge (up to 30 days).
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The frequency and type of adverse events occurring during CDSS-guided mobilization, including hemodynamic instability (MAP <65 mmHg or SBP drop >20 mmHg), oxygen desaturation (SpO₂ <90% for >30 seconds), or device dislodgement (unplanned removal of EVD, central line, or ventilator tubing).
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From the first mobilization session until ICU discharge (up to 30 days).
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Collaboratori e investigatori
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Disturbi cerebrovascolari
- Malattie del cervello
- Malattie del sistema nervoso centrale
- Malattie del sistema nervoso
- Malattie vascolari
- Malattia cardiovascolare
- Ferite e lesioni
- Processi patologici
- Emorragia
- Trauma craniocerebrale
- Trauma, sistema nervoso
- Emorragie intracraniche
- Ictus
- Lesioni cerebrali
- Condizioni patologiche, segni e sintomi
- Ictus ischemico
- Lesioni cerebrali, traumatiche
- Emorragia cerebrale
- Emorragia subaracnoidea
Altri numeri di identificazione dello studio
- 202507222RINA
- 115S (Altro numero di sovvenzione/finanziamento: National Taiwan University Hospital)
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Informazioni su farmaci e dispositivi, documenti di studio
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Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .
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