CT C-spine Audit and Feedback

NCT05711134 | Completed

• 1 other identifier: STUDY00000533
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

This is a prospective quality improvement study to assess the effect of using an audit-and-feedback process for emergency providers on utilization of computed tomography of the cervical spine. The objective of this study is to determine whether providing repeated individualized feedback on CT C-spine utilization to emergency providers alters their practice pattern and reduces overutilization. The investigators hypothesize that emergency providers who receive individualized feedback regarding their CT C-spine utilization on a regular basis will alter their practice pattern to reduce overutilization of this imaging study.

Conditions

Cervical Spine Injury; Emergencies; Trauma

Keywords

computed tomography; resource utilization; NEXUS; emergency medicine

Outcome Measures

Primary Outcomes (1)

• Percent NEXUS-Negative

  Percentage of CT C-spine studies that an individual provider ordered on NEXUS-negative patients

  6 months

Secondary Outcomes (3)

• Number of Fractures

  6 months

• Clinically Significant Fractures

  6 months

• Number of CTs

  6 months

Study Arms (3)

Serial In-Person Feedback

EXPERIMENTAL

Providers are given recurring individualized in-person feedback on their practice patterns.

Behavioral: Audit and Feedback on Individual Practice Patterns

In-Person Feedback with Serial Electronic Feedback

EXPERIMENTAL

Providers are given one-time individualized in-person feedback on their practice patterns, followed by recurrent individualized electronic feedback.

Behavioral: Audit and Feedback on Individual Practice Patterns

Control

NO INTERVENTION

Providers are not given any feedback on their practice patterns.

Interventions

Audit and Feedback on Individual Practice Patterns BEHAVIORAL

Providers are given feedback on their practice patterns of ordering computed tomography of the cervical spine.

In-Person Feedback with Serial Electronic Feedback; Serial In-Person Feedback

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Emergency medicine physician, nurse practitioner, or physician assistant
• Ordered at least 5 CT scans of the cervical spine on adult patients in the two-month pre-intervention period

You may not qualify if:

• Non-emergency providers
• Ordered few than 5 studies in the pre-intervention period

Sponsors & Collaborators

• University of Massachusetts, Worcester: lead

Study Sites (1)

University of Massachusetts Chan Medical School

Worcester, Massachusetts, 01655, United States

Location

MeSH Terms

Conditions

Emergencies; Wounds and Injuries

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Karl T Chamberlin, MD

  University of Massachusetts Chan Medical School

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professsor

Study Record Dates

• First Submitted: January 24, 2023
• First Posted: February 2, 2023
• Study Start: May 1, 2023
• Primary Completion: October 31, 2023
• Study Completion: October 31, 2023
• Last Updated: November 9, 2023

Record last verified: 2023-11

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)