N/A N=1,799 Randomized Health Services Research

EHR-based Decision Support for Pediatric Acute Abdominal Pain in Emergency Care

Appendicitis

Bottom Line

View on ClinicalTrials.gov: NCT02633735 ↗

Enrolled (actual)

1,799

Serious AEs

3.5%

Results posted

Jul 2020

Primary outcome: Primary: Pre to Post Ratio of Image Use — 1.13; 1.07; 1.03; 1.01 ratio of pre-post use

Study Design & Population

Study type: Interventional
Phase: N/A
Interventions: Appy CDS (Other)
Age: Pediatric, Adult · 5+ yrs
Sex: All
Sponsor: HealthPartners Institute
Primary completion: Jul 2019

Outcome Measures

Outcome	Result	p-value
PRIMARY Pre to Post Ratio of Image Use	1.13; 1.07; 1.03; 1.01; 1.06; 1.02	—

Summary

Although appendicitis is the most common surgical emergency in children, its diagnosis remains a challenge and thus, emergency department (ED) providers increasingly rely on computed tomography to distinguish appendicitis from other conditions. This project (a) uses electronic health record (EHR) technology to deliver patient-specific clinical decision support to ED providers at the point of care, (b) assesses the impact of this intervention on the use of diagnostic imaging and clinical outcomes, and (c) assesses the impact of the intervention on the costs of care delivered. This innovative project will be a template for extending EHR-based clinical decision support to other domains of emergency care to ultimately improve a broad range of pediatric acute care outcomes. The proposed intervention, referred to as appy-CDS, is specifically designed for widespread use in EDs and could reduce reliance on advanced diagnostic imaging for pediatric and adolescent patients with acute abdominal pain while maintaining or improving clinical outcomes. Investigators aim to develop and implement an interactive, evidence-based clinical decision support tool to optimize care for children and adolescents presenting to a general or non-pediatric ED with acute abdominal pain.

Eligibility Criteria

Inclusion Criteria

children and adolescents ages 5-20 years with abdominal pain
internal med, family med, or emergency med trained providers at participating EDs

Exclusion Criteria

select comorbid conditions
previous abdominal surgery
treated for select comorbid conditions

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02633735). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.