Education and Feedback Intervention to Reduce Inappropriate Transthoracic Echocardiograms
2014年2月10日 更新者：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.
研究概览
地位
未知
详细说明
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.
研究类型
介入性
注册 (预期的)
150
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。
学习地点
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Massachusetts
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Boston、Massachusetts、美国、02114
- 招聘中
- Massachusetts General Hospital
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接触：
- Rory B Weiner, MD
- 电话号码：617-724-0358
- 邮箱：rweiner@partners.org
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首席研究员：
- Rory B Weiner, MD
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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
- 孩子
- 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:
- Cardiology Attending physicians at Massachusetts General Hospital
- Primary care physicians at Massachusetts General Hospital
Exclusion Criteria:
- Physicians-in-training
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：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：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.
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无干预：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.
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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 |
|---|---|---|
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Rate of Inappropriate transthoracic echocardiograms
大体时间：12 months
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Rate of inappropriate echocardiograms determined from a review of the electronic medical record.
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12 months
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Rate of Appropriate transthoracic echocardiograms
大体时间：12 months
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Rate of appropriate transthoracic echocardiograms determined from a review of the electronic medical record.
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12 months
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Clinical reasons for appropriate and inappropriate transthoracic echocardiograms
大体时间：12 months
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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.
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12 months
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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。
调查人员
- 首席研究员：Rory B Weiner, MD、Massachusetts General Hospital
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Bhatia RS, Milford CE, Picard MH, Weiner RB. An educational intervention reduces the rate of inappropriate echocardiograms on an inpatient medical service. JACC Cardiovasc Imaging. 2013 May;6(5):545-55. doi: 10.1016/j.jcmg.2013.01.010. Epub 2013 Apr 10.
- Dudzinski DM, Bhatia RS, Mi MY, Isselbacher EM, Picard MH, Weiner RB. Effect of Educational Intervention on the Rate of Rarely Appropriate Outpatient Echocardiograms Ordered by Attending Academic Cardiologists: A Randomized Clinical Trial. JAMA Cardiol. 2016 Oct 1;1(7):805-812. doi: 10.1001/jamacardio.2016.2232.
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
2013年11月1日
初级完成 (预期的)
2014年10月1日
研究完成 (预期的)
2014年10月1日
研究注册日期
首次提交
2013年10月20日
首先提交符合 QC 标准的
2013年10月20日
首次发布 (估计)
2013年10月24日
研究记录更新
最后更新发布 (估计)
2014年2月11日
上次提交的符合 QC 标准的更新
2014年2月10日
最后验证
2014年2月1日
更多信息
与本研究相关的术语
其他研究编号
- 2011P001779 AME3
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.