NCT02625181

Brief Summary

The purpose of this study is to determine how automated recommendations are best presented to optimize the adherence to guidelines on prophylaxis for nausea and vomiting after surgery.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
27,034

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jul 2016

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 12, 2015

Completed
27 days until next milestone

First Posted

Study publicly available on registry

December 9, 2015

Completed
7 months until next milestone

Study Start

First participant enrolled

July 1, 2016

Completed
1.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 2, 2017

Completed
28 days until next milestone

Study Completion

Last participant's last visit for all outcomes

November 30, 2017

Completed
1.3 years until next milestone

Results Posted

Study results publicly available

March 7, 2019

Completed
Last Updated

March 7, 2019

Status Verified

March 1, 2019

Enrollment Period

1.3 years

First QC Date

November 12, 2015

Results QC Date

October 30, 2018

Last Update Submit

March 5, 2019

Conditions

Keywords

Decision supportPrediction modelsPONVprophylaxisDecision Support Systems, ClinicalDecision Support Techniques

Outcome Measures

Primary Outcomes (1)

  • Adherence to PONV Guidelines

    PONV guideline adherence: percentage of patients who received the exact number of prophylactic interventions for PONV that were recommended by the decision support.

    A specific time frame on the day of surgery: the start of admission at the holding room to the end of the anesthetic case

Secondary Outcomes (3)

  • PONV Incidence: Number of Participants With Postoperative Nausea and Vomiting

    PACU recovery period

  • The Number of Prophylactic Interventions for PONV

    A specific time frame on the day of surgery: from the start of admission at the holding room to the end of the anesthetic case

  • Time to Discharge From the Postanesthesia Care Unit (PACU)

    A specific time frame on the day of surgery: from the start of admission to the PACU to discharge from the PACU

Study Arms (1)

PONV clinical decision support system

EXPERIMENTAL

Automated recommendations on PONV prophylaxis provided to anesthesia providers through the anesthesia information management system and email.

Procedure: Automated recommendation at the start of the caseProcedure: Automated notification at the start of surgeryProcedure: Preoperative recommendations: by emailProcedure: Automated notification at the end of surgeryDevice: Anesthesia Information Management System (AIMS)Device: Perioperative Data Warehouse (PDW)Procedure: General anesthesiaProcedure: Elective surgeryDrug: PropofolDrug: SevofluraneDrug: IsofluraneDrug: DesfluraneDrug: ScopolamineDrug: DroperidolDrug: HaloperidolDrug: DexamethasoneDrug: PromethazineDrug: MeclizineDrug: AprepitantDrug: MetoclopramideDrug: FentanylDrug: SufentanilDrug: AlfentanilDrug: RemifentanilDrug: MorphineDrug: MeperidineDrug: HydromorphoneDrug: MethadoneDrug: OxycodoneDrug: OxymorphoneDrug: HydrocodoneDrug: KetamineDrug: OndansetronDrug: GranisetronDrug: Dolasetron mesylateDrug: PalonosetronDrug: TropisetronDrug: Ramosetron

Interventions

The first notification is the main notification that informs the anesthesia providers at the start of anesthesia of the risk score for that individual patient and the recommended number of prophylactic interventions. The notification occurs within the anesthesia information management system (AIMS)

PONV clinical decision support system

The second notification within the AIMS will notify the anesthesia providers at the start of surgery when no prophylaxis has been given while three or more interventions were recommended.

PONV clinical decision support system

A recommendation on PONV prophylaxis to anesthesia providers through email at the Vanderbilt University Medical Center.

PONV clinical decision support system

A notification will remind anesthesia providers at the closing of surgery how many prophylactic interventions are required to adhere to the recommended number of interventions.

PONV clinical decision support system

The anesthesia electronic record keeping system

PONV clinical decision support system

The data warehouse that is used to gather perioperative data and create user reports. In this instance the PDW will be used to send the preoperative emails.

PONV clinical decision support system

Any anesthetic drugs that are used to induce general anesthesia above the level of sedation.

PONV clinical decision support system

Surgical procedures that are scheduled and not an emergency.

PONV clinical decision support system

Anesthetic drug used to maintain general anesthesia

PONV clinical decision support system

Anesthetic drug used to maintain general anesthesia

PONV clinical decision support system

Anesthetic drug used to maintain general anesthesia

PONV clinical decision support system

Anesthetic drug used to maintain general anesthesia

PONV clinical decision support system

Prophylactic antiemetic

PONV clinical decision support system

Prophylactic antiemetic \& rescue antiemetic

PONV clinical decision support system

Prophylactic antiemetic \& rescue antiemetic

PONV clinical decision support system

Prophylactic antiemetic \& rescue antiemetic

PONV clinical decision support system

Prophylactic antiemetic \& rescue antiemetic

PONV clinical decision support system

Prophylactic antiemetic \& rescue antiemetic

PONV clinical decision support system

Prophylactic antiemetic \& rescue antiemetic

PONV clinical decision support system

Rescue antiemetic

PONV clinical decision support system

Analgesic drug / Opioid

PONV clinical decision support system

Analgesic drug / Opioid

PONV clinical decision support system

Analgesic drug / Opioid

PONV clinical decision support system

Analgesic drug / Opioid

PONV clinical decision support system

Analgesic drug / Opioid

PONV clinical decision support system

Analgesic drug / Opioid

PONV clinical decision support system

Analgesic drug / Opioid

PONV clinical decision support system

Analgesic drug / Opioid

PONV clinical decision support system

Analgesic drug / Opioid

PONV clinical decision support system

Analgesic drug / Opioid

PONV clinical decision support system

Analgesic drug / Opioid

PONV clinical decision support system

Analgetic / Analgesic drug

PONV clinical decision support system

Prophylactic antiemetic \& rescue antiemetic

PONV clinical decision support system

Prophylactic antiemetic \& rescue antiemetic

PONV clinical decision support system

Prophylactic antiemetic \& rescue antiemetic

PONV clinical decision support system

Prophylactic antiemetic \& rescue antiemetic

PONV clinical decision support system

Prophylactic antiemetic \& rescue antiemetic

PONV clinical decision support system

Prophylactic antiemetic \& rescue antiemetic

PONV clinical decision support system

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • All adult patients (18 years and older) that are scheduled for an elective surgical procedure under general anesthesia

You may not qualify if:

  • Patients undergoing emergency surgery or organ transplantation
  • Patients that are transferred directly to the Intensive Care Unit after the end of the procedure
  • Patients that die intraoperatively
  • Procedures that only require a sedative level of anesthesia

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Vanderbilt University Medical Center

Nashville, Tennessee, 37212, United States

Location

MeSH Terms

Conditions

Postoperative Nausea and Vomiting

Interventions

Anesthesia, GeneralElective Surgical ProceduresPropofolSevofluraneIsofluraneDesfluraneScopolamineDroperidolHaloperidolDexamethasonePromethazineMeclizineAprepitantMetoclopramideFentanylSufentanilAlfentanilRemifentanilMorphineMeperidineHydromorphoneMethadoneOxycodoneOxymorphoneHydrocodoneKetamineOndansetronGranisetrondolasetronPalonosetronTropisetronramosetron

Condition Hierarchy (Ancestors)

Postoperative ComplicationsPathologic ProcessesPathological Conditions, Signs and SymptomsNauseaSigns and Symptoms, DigestiveSigns and SymptomsVomiting

Intervention Hierarchy (Ancestors)

AnesthesiaAnesthesia and AnalgesiaSurgical Procedures, OperativePhenolsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsMethyl EthersEthersHydrocarbons, FluorinatedHydrocarbons, HalogenatedEthyl EthersScopolamine DerivativesTropanesAzabicyclo CompoundsAza CompoundsBelladonna AlkaloidsSolanaceous AlkaloidsAlkaloidsHeterocyclic CompoundsBridged Bicyclo Compounds, HeterocyclicHeterocyclic Compounds, Bridged-RingButyrophenonesKetonesBenzimidazolesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingPregnadienetriolsPregnadienesPregnanesSteroidsFused-Ring CompoundsPolycyclic CompoundsSteroids, FluorinatedPropylaminesAminesPhenothiazinesSulfur CompoundsHeterocyclic Compounds, 3-RingBenzhydryl CompoundsPiperazinesHeterocyclic Compounds, 1-RingMorpholinesOxazinesBenzamidesAmidespara-AminobenzoatesAminobenzoatesBenzoatesAcids, CarbocyclicCarboxylic AcidsChlorobenzoatesHydroxybenzoate EthersHydroxybenzoatesHydroxy AcidsPhenyl EthersPiperidinesPropionatesAcids, AcyclicMorphine DerivativesMorphinansOpiate AlkaloidsHeterocyclic Compounds, 4 or More RingsPhenanthrenesPolycyclic Aromatic HydrocarbonsIsonipecotic AcidsAcids, HeterocyclicCodeineCyclohexanesCycloparaffinsHydrocarbons, AlicyclicImidazolesAzolesCarbazolesIndolesIndazolesPyrazolesQuinuclidinesIsoquinolines

Limitations and Caveats

We were unable to complete analysis of hyperlink data for PONV recommendations as planned because the data were not archived as intended. We were unable to include University of Washington as a collaborative site due to technical differences.

Results Point of Contact

Title
Jonathan Wanderer
Organization
Vanderbilt University Medical Center

Study Officials

  • Jonathan P Wanderer, MD, MPhil

    Vanderbilt University Medical Center, Division of Anesthesiology

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
PREVENTION
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Medical Director of Procedure Preparation Center

Study Record Dates

First Submitted

November 12, 2015

First Posted

December 9, 2015

Study Start

July 1, 2016

Primary Completion

November 2, 2017

Study Completion

November 30, 2017

Last Updated

March 7, 2019

Results First Posted

March 7, 2019

Record last verified: 2019-03

Data Sharing

IPD Sharing
Will not share

Locations