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CirrosisRx CDS 系统

2026年11月3日 更新者:University of California, San Francisco

评估 CirrosisRx(一种新型临床决策支持系统)对肝硬化患者的指南依从性和临床结果的影响的实用随机对照试验

The aim of the study is to compare the effect of CirrhosisRx, a novel clinical decision support (CDS) system for inpatient cirrhosis care, versus "usual care" on adherence to national quality measures and clinical outcomes for hospitalized patients with cirrhosis.

研究概览

地位

招聘中

条件

干预/治疗

详细说明

Each year, there over 200,000 hospitalizations for cirrhosis in the United States. Over one-third of these patients are readmitted within 30 days, and up to 10% will die in the hospital. Despite national quality measures and care guidelines, cirrhosis care remains suboptimal and highly variable.

Clinical Decision Support (CDS) systems present an attractive strategy to improve guideline-adherence due to low implementation costs. These systems, however, remain largely untested in cirrhosis care and it remains unknown whether they are effective at improving guideline-adherence and whether improving guideline-adherence changes clinical outcomes in cirrhosis care. The investigators have designed "CirrhosisRx," a cirrhosis-specific CDS system, to address these evidence gaps.

This study intends to compare effect of CirrhosisRx versus "usual care" on adherence to quality measures and clinical outcomes through a pragmatic randomized controlled trial (pRCT). Randomization will be based on stepped-wedge cluster randomization of treatment teams at our institution.

研究类型

介入性

注册 (估计的)

2106

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习联系方式

  • 姓名:Jin Ge, MD, MBA
  • 电话号码:415-502-8070
  • 邮箱:jin.ge@ucsf.edu

学习地点

    • California
      • San Francisco、California、美国、94143
        • 招聘中
        • University of California San Francisco Medical Center
        • 接触:

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

描述

Inclusion Criteria:

  • All adult (age ≥ 18 years) patients who have cirrhosis identified based on 1+ chronic liver disease and 1+ cirrhosis (or its complications) International Classification of Diseases, Revision 10 diagnosis codes OR mention of cirrhosis or portal hypertension (or their complications) in clinical documentation admitted at our institution.

Exclusion Criteria:

  • Children (age < 18 years)
  • patients who do not meet the cirrhosis definition criteria as noted above
  • ambulatory patients

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:卫生服务研究
  • 分配:随机化
  • 介入模型:交叉作业
  • 屏蔽:无(打开标签)

武器和干预

参与者组/臂
干预/治疗
实验性的:CirrhosisRx

Providers in this arm will have access to the CirrhosisRx CDS system, which aggregates and organizes clinical data, presents them in clinically relevant/intuitive fashion for cirrhosis care, and linked to order sets consistent with national guidelines.

CirrhosisRx is a cirrhosis-specific CDS that organizes clinical data into clinically relevant groupings and links them to order sets consistent with national practice guidelines for inpatient cirrhosis care.

无干预:Usual Care

Providers in this arm will not have access to the CirrhosisRx CDS system.

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Aggregate adherence to quality measures
大体时间:During the hospitalization, approximately 7 days

This outcome is the aggregate adherence to five American Gastroenterological Association (AGA) and American Association for the Study of Liver Disease (AASLD) quality measures applicable to hospitalized patients with cirrhosis. The calculation for the measure will be the total number of admissions satisfying the five AGA/AASLD quality measures divided by the total number of addressable admissions (e.g. hospitalizations in which these quality metrics could be applied). In the cases which an admission could satisfying two or more metrics, this single admission will be multiple times per the number of times metrics could be potentially applied.

During the hospitalization, approximately 7 days

次要结果测量

结果测量
措施说明
大体时间
Inpatient mortality
大体时间:During the hospitalization, approximately 7 days

This outcome is death during the admission

During the hospitalization, approximately 7 days

其他结果措施

结果测量
措施说明
大体时间
Reach of CirrhosisRx
大体时间:Through study completetion, approximately 36 months

Number of patients and clinicians randomized to CirrhosisRx

Through study completetion, approximately 36 months
Adoption of CirrhosisRx
大体时间:Through study completetion, approximately 36 months

Proportion of clinicians using CirrhosisRx in the intervention arm

Through study completetion, approximately 36 months
Implementation of CirrhosisRx
大体时间:Through study completetion, approximately 36 months

Proportions of clinicians implementing an order set through CirrhosisRx

Through study completetion, approximately 36 months
Maintenance of CirrhosisRx
大体时间:Through study completetion, approximately 36 months

Rate of use over time and contamination rate

Through study completetion, approximately 36 months
Average time spent on CirrhosisRx
大体时间:Through study completetion, approximately 36 months

Average time spent on CirrhosisRx - defined as the total time all clinicians spent on the system divided by the number of clinicians using the system

Through study completetion, approximately 36 months

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

调查人员

  • 首席研究员:Jin Ge, MD, MBA、University of California, San Francisco

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2025年1月14日

初级完成 (估计的)

2027年1月1日

研究完成 (估计的)

2027年1月1日

研究注册日期

首次提交

2023年6月8日

首先提交符合 QC 标准的

2023年7月20日

首次发布 (实际的)

2023年8月1日

研究记录更新

最后更新发布 (实际的)

2026年11月5日

上次提交的符合 QC 标准的更新

2026年11月3日

最后验证

2026年11月1日

更多信息

与本研究相关的术语

其他研究编号

  • 23-39379

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

不

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

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