CirrosisRx CDS 系统
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
地位
干预/治疗
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
研究类型
注册 (估计的)
注册
阶段
阶段
- 不适用
联系人和位置
学习联系方式
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:
- Jin Ge, MD, MBA
- 电话号码:415-502-8070
- 邮箱:jin.ge@ucsf.edu
-
-
参与标准
资格标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
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
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)
手臂数量
武器和干预
参与者组/臂参与者组/臂 |
干预/治疗干预/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
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
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
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
调查人员
调查人员
- 首席研究员:Jin Ge, MD, MBA、University of California, San Francisco
研究记录日期
研究主要日期
学习开始 (实际的)
学习开始
初级完成 (估计的)
初级完成
研究完成 (估计的)
研究完成
研究注册日期
首次提交
首次提交
首先提交符合 QC 标准的
首先提交符合 QC 标准的
首次发布 (实际的)
首次发布
研究记录更新
最后更新发布 (实际的)
最后更新发布
上次提交的符合 QC 标准的更新
上次提交的符合 QC 标准的更新
最后验证
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
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)?
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
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