Equity in Diagnostic Imaging Trial

NCT01611714 | Completed

• 2 other identifiers: GCO 02-0515(3)3P60MD000270-09S1
• Study Type: interventional
• Target: 181
• Locations: 1 country
• Sites: 1

Brief Summary

This study will 1) Develop two interventions: a) an audit-feedback email intervention that provides clinicians with data on CT scan ordering practices by patient race; and b) a clinical decision support (CDS) message in the electronic medical record headache template; and 2) Compare the effectiveness of these 2 interventions in eliminating a previously observed Black-White disparity in CT scanning rates to rule out subarachnoid hemorrhage (SAH).

Conditions

Headache

Keywords

Racial/ethnic disparities; Imaging; Emergency; Headache

Outcome Measures

Primary Outcomes (1)

• Change in CT usage rate

  What is the impact of the email intervention, CDS intervention, and combined intervention on black-white difference in CT rates? A successful intervention should lead to a significant main effect for each experimental arm.

  up to 24 months

Study Arms (4)

Audit-feedback

EXPERIMENTAL

Arm 1: Audit-feedback only

Other: Audit-feedback

CDS message

EXPERIMENTAL

Arm 2: CDS message only

Other: Clinical Decision Support

Both Interventions

EXPERIMENTAL

Arm 3: Audit-feedback and CDS message

Other: Audit-feedback; Other: Clinical Decision Support

Control

NO INTERVENTION

Arm 4: Control

Interventions

Audit-feedback OTHER

Clinicians will receive a short email educational message at regular intervals alerting them to the historic disparities in diagnostic workup for SAH in our department and reminding them of the increased risk of SAH among African-American patients.

Audit-feedback; Both Interventions

Clinical Decision Support OTHER

Clinicians receive an embedded real-time Best Practice Alert (BPA) of increased rates of SAH among African-Americans when they open the "headache" electronic charting template.

Also known as: CDS

Both Interventions; CDS message

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Attending Physicians, Emergency Room Resident Physicians, and PA's will be included if:
• they provide care to adult patients in the emergency department of Mount Sinai Hospital.
• Patients will be enrolled for medical record review if
• they present with a complaint of headache and charted on the headache template in the period between four years pre-intervention and the end of the study period.

Sponsors & Collaborators

• Icahn School of Medicine at Mount Sinai: lead
• National Institute on Minority Health and Health Disparities (NIMHD): collaborator

Study Sites (1)

Icahn School of Medicine at Mount Sinai

New York, New York, 10029, United States

Location

MeSH Terms

Conditions

Headache; Emergencies

Condition Hierarchy (Ancestors)

Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Disease Attributes; Pathologic Processes

Study Officials

• Lynne D Richardson, MD

  Icahn School of Medicine at Mount Sinai

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 13, 2012
• First Posted: June 5, 2012
• Study Start: July 1, 2010
• Primary Completion: December 1, 2015
• Study Completion: December 1, 2015
• Last Updated: January 29, 2016

Record last verified: 2016-01

Locations

US (1)