computer reminders on clinical practice

Control group

Alessandro Passardi, MD

Implementing an evidence-based computerized decision support system linked to electronic health records to improve care for cancer patients.

The ONCO-CODES (Computerized DEcision Support in ONCOlogy) trial is a pragmatic, parallel group, randomized controlled study with 1:1 allocation ratio Study Duration 12 month Study Center(s) Single-center

Objectives:

The primary outcome of this trial is a process outcome. i.e. the rate at which the issues reported by the reminders are resolved (resolution rates).

Implementing an evidence-based computerized decision support system linked to electronic health records to improve care for cancer patients.

Short Title/Acronym ONCO-CODES Protocol Code IRST100.23

Rationale:

Computerized decision support systems (CDSSs) are computer programs that provide clinicians, staff, patients, or other individuals with person-specific, actionable recommendations or management options that are intelligently filtered or presented at appropriate times to enhance health and health care. CDSSs might be integrated with patient electronic health records (EHRs) and evidence-based knowledge. The Investigators designed a pragmatic randomized controlled trial to evaluate the effectiveness of patient-specific, point-of-care reminders generated by the Medilogy Decision Support System (MediDSS) on clinical practice and the quality of care in the Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS. The Investigators hypothesize that MediDSS reminders can increase clinician adherence to guidelines and, eventually, improve the quality of care offered to hospitalized patient. The adoption of CDSSs is likely to increase across healthcare systems due to growing concerns about the quality of medical care and discrepancy between real and ideal practice, continuous calls for a meaningful use of health information technology, and the increasing use of and familiarity with advanced technology among new generations of physicians.

Study Design:

The ONCO-CODES (Computerized DEcision Support in ONCOlogy) trial is a pragmatic, parallel group, randomized controlled study with 1:1 allocation ratio Study Duration 12 month Study Center(s) Single-center

Objectives:

The primary outcome of this trial is a process outcome. i.e. the rate at which the issues reported by the reminders are resolved (resolution rates).

Number of Subjects:

The investigators calculated the sample size on the basis of the primary outcome. A sample of 1,704 reminders will be necessary to detect the difference between the two groups (power = 0.90; α =0.05, two-sided; 1:1 allocation). Since estimates for intracluster correlation are not available, Implementing an evidence-based computerized decision support system linked to electronic health records to improve care for cancer patients.

Diagnosis and Main Inclusion Criteria:

The investigators will include all the patients admitted to the facilities of the IRST IRCCS. There are no exclusion criteria

Statistical Methodology:

All analyses will follow the intention-to-treat principle: patients will be analyzed in the group to which they have been randomized. Descriptive statistics will be presented.

All statistical tests will be two-sided. The investigators will use the Stata software to perform all statistical analyses (Stata Corp., College Station, TX, USA).The investigators increased the required sample size (by 20%) to 2,046 reminders to account for clustering by patient.

Implementing an Evidence-based Computerized Decision Support System Linked to Electronic Health Records to Improve Care for Cancer Patients

Effect on Professional Practice and Health Care Outcomes of Computerized Evidence-based Information System and Clinical Decision Support: A Randomized Controlled Trial in Orthopaedics (GR-2009-1606736)

the rate at which the issues reported by the reminders are resolved

Ministry of Health, Italy

University of Milan

I.R.C.C.S Ospedale Galeazzi-Sant'Ambrogio

Catholic University of the Sacred Heart

Duodecim, Finnish Medical Association, Helsinki

Mario Negri Institute for Pharmacological Research

Ottawa Hospital Research Institute

Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori

Immune System Diseases

All Conditions

Hypersensitivity

Robert Friedman, MD

The purpose of this study is to develop a tool that can more accurately assess the intensity and kind of physical activity that a person performs. The experimental tool, which will use a mobile computing device as a way of automatically identifying when a certain activity is being performed and at what intensity, will be tested against a self reported paper diary of activities performed on a day to day basis. It is hoped that this study will increase understanding of the health benefits of certain types of physical activity performed in the home.

Engaging in regular physical activity that requires a moderate to vigorous effort is related to good health and a reduced risk of a multitude of diseases. Currently physical activity and health promotion research is limited by self- report data that is confounded by participants' ability to accurately remember and record their physical activity. A potentially new method of accurately assessing moderate-intensity physical activity is called context sensitive- ecological momentary assessment (CS-EMA). Mobile computing devices (personal computing devices, PDAs) that automatically identify when a specific type of physical activity (e.g., moderate-intensity physical activity) is being performed has the potential to provide valuable objective data for naturalistic, experimental, and clinical intervention research purposes, and has the potential for educational, recreational, and clinical applications. The goal of this exploratory study is to assess the accuracy of two methods of collecting data on moderate-intensity physical activity. The study will compare the use of a paper diary to collect self-reported data on moderate-intensity physical activities performed throughout the day to self-reported data collected using ecological momentary assessment methods which are facilitated by a PDA that cues the participant to record when specific intensity levels of physical activity are achieved. This study will also develop algorithms that will automatically identify specific types of physical activities being performed. The data collected from the heart rate monitor, motion sensor, and information requested directly from the participant via the PDA interface will be used to train pattern recognition systems to classify the intensity and type of physical activity being performed by the participant. This study will contribute to research on context- awareness and human activity recognition.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Implementing an Evidence-based Computerized Decision Support System Linked to Electronic Health Records to Improve Care for Cancer Patients	NCT02645357	Medical Oncolog...	computer remind... Control group	18 Years -	Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori
Implementing an Evidence-based Computerized Decision Support System Linked to Electronic Health Records to Improve Care for Cancer Patients	NCT02645357	Medical Oncolog...	computer remind... Control group	18 Years -	Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori
The Development and Testing of an Electronic Tool to Measure Physical Activity in Domestic Settings	NCT00207181	Cancer		18 Years -	Boston Medical Center

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