Nudging Provider Adoption of Clinical Decision Support: Implementation of an EHR-Agnostic Pulmonary Embolism Risk Prediction Tool
2 other identifiers
interventional
440
1 country
3
Brief Summary
The purpose of this study is to examine the impact of the nudge implementation strategy (CDS tool + Nudge) on adoption of guideline-concordant CT ordering for pulmonary embolism (PE) in 10 EDs. The study will be a 33-month, rigorous, pragmatic, cluster-randomized, stepped wedge trial across 3 health systems and 10 EDs after collecting pre-implementation baseline data. The aim is to to demonstrate technological feasibility as well as examine efficacy of the nudges on adoption. The secondary objective is to decrease CT-ordering when it is not indicated.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Feb 2026
Typical duration for not_applicable
3 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
November 18, 2025
CompletedFirst Posted
Study publicly available on registry
November 25, 2025
CompletedStudy Start
First participant enrolled
February 15, 2026
CompletedPrimary Completion
Last participant's last visit for primary outcome
July 1, 2028
ExpectedStudy Completion
Last participant's last visit for all outcomes
March 31, 2029
January 22, 2026
November 1, 2025
2.4 years
November 18, 2025
January 21, 2026
Conditions
Outcome Measures
Primary Outcomes (2)
Percentage of CT scan orders that are guideline-concordant
Guideline-concordant is defined as CT scan orders with Wells' Score \>4 \["PE Likely"\] and/or d-dimer above upper limit of normal.
Baseline (Month 12)
Percentage of CT scan orders that are guideline-concordant
Guideline-concordant is defined as CT scan orders with Wells' Score \>4 \["PE Likely"\] and/or d-dimer above upper limit of normal.
End of intervention (Month 45)
Study Arms (1)
Emergency Department (ED) Providers
EXPERIMENTALEach ED will serve as its own control. Baseline data will be collected for 12 months prior to the implementation of the CDS system with nudges. The CDS tool with nudges will then be implemented for 33 months.
Interventions
The CDS tool with nudges provide information to providers to practice medicine in accordance with CT (computed tomography) ordering guidelines. The tool will only deploy when the provider is going against clinical guidelines and therefore provides a chance for the provider to reconsider their actions.
Eligibility Criteria
You may qualify if:
- years of older
- A provider (MD, NP, PA) ordering CTs for evaluation of PE in adult patients present at study site Emergency Department (i.e., Northwell Health - Feinstein Institute for Medical Research, Baylor College of Medicine and NYU Langone Health).
You may not qualify if:
- \. A provider not present at the specified study sites.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (3)
Northwell Health - Feinstein Institute for Medical Research
Manhasset, New York, 11030, United States
NYU Langone Health
New York, New York, 10016, United States
Baylor College of Medicine
Houston, Texas, 77030, United States
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Safiya Richardson, MD MPH
NYU Langone Health
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- NA
- Masking
- NONE
- Purpose
- SUPPORTIVE CARE
- Intervention Model
- SINGLE GROUP
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
November 18, 2025
First Posted
November 25, 2025
Study Start
February 15, 2026
Primary Completion (Estimated)
July 1, 2028
Study Completion (Estimated)
March 31, 2029
Last Updated
January 22, 2026
Record last verified: 2025-11
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP
- Time Frame
- Beginning 9 months and ending 36 months following article publication or as required by a condition of awards and agreements supporting the research.
- Access Criteria
- The investigator who proposed to use the data will be granted access upon reasonable request. Requests should be directed to Safiya.richardson@nyulangone.org. To gain access, data requestors will need to sign a data access agreement. This instance of data sharing will also require separate IRB review as well as review from NYU Langone's DSSB.
The de-identified participant data from the final research dataset will be shared upon reasonable request beginning 9 to 36 months after publication or as required by a condition of awards or supporting agreements, provided the requesting investigator executes a data use agreement with NYU Langone Health. This instance of data sharing will also require separate IRB review as well as review from NYU Langone's Data Sharing Strategy Board (DSSB). Requests should be directed to: Safiya.richardson@nyulangone.org. The protocol and statistical analysis plan will be posted on Clinicaltrials.gov only as required by federal regulation or supporting awards and agreements.