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Effect of Teledermatology on Length of Hospital Admission, Length of Stay, 30 Day Readmission Rate, and Antibiotic Use in Patients Presenting With Cellulitis vs Pseudocellulitis in an Academic ED Setting

Primary Purpose

Cellulitis

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
teledermatology consult
Routine Care
Sponsored by
Ohio State University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Cellulitis

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Over 18
  • Present to the ED with cellulitis-like symptoms, including but not limited to the following: tenderness, redness, swelling, expansive lesion

Exclusion Criteria:

  • pregnant
  • prisoner

Sites / Locations

  • The Ohio State University Wexner Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Other

Other

Arm Label

Teledermatology consult

Routine Care

Arm Description

To determine the benefit of teledermatology to differentiate cellulitis from pseudocellulitis in emergency departments through the analysis of time spent in the emergency department (ED), admission to the inpatient hospital, antibiotic use, time to improvement, and 30-day remission rate. This arm will undergo imaging, a dermatologic assessment will be performed, AND this assessment will be entered into the patients chart.

To determine the benefit of teledermatology to differentiate cellulitis from pseudocellulitis in emergency departments through the analysis of time spent in the emergency department (ED), admission to the inpatient hospital, antibiotic use, time to improvement, and 30-day remission rate. This arm will undergo imaging, a dermatologic assessment will be performed, AND this assessment WILL NOT be entered into the patients chart

Outcomes

Primary Outcome Measures

Admission to the hospital
To determine the benefit of teledermatology to differentiate cellulitis from pseudocellulitis in emergency departments through the analysis of time spent in the emergency department (ED), admission to the inpatient hospital, antibiotic use, time to improvement, We anticipate a high rate of pseudocellulitis, and this aim will determine if there is a difference in patient admissions among those who receive a dermatologic assessment

Secondary Outcome Measures

Length of stay in the hospital
Will assess time spent in the hospital for those that were admitted
30 day readmission rate
Will assess hospitalization/emergency department readmission in the following 30 days
Antibiotic use
Will assess the frequency of antibiotic use between groups

Full Information

First Posted
June 4, 2016
Last Updated
April 3, 2018
Sponsor
Ohio State University
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1. Study Identification

Unique Protocol Identification Number
NCT03036358
Brief Title
Effect of Teledermatology on Length of Hospital Admission, Length of Stay, 30 Day Readmission Rate, and Antibiotic Use in Patients Presenting With Cellulitis vs Pseudocellulitis in an Academic ED Setting
Official Title
The Effect of Teledermatology on Length of Hospital Admission, Length of Stay, 30 Day Readmission Rate, and Antibiotic Use in Patients Presenting With Cellulitis vs Pseudocellulitis in an Academic Emergency Department Setting.
Study Type
Interventional

2. Study Status

Record Verification Date
April 2018
Overall Recruitment Status
Completed
Study Start Date
January 2016 (undefined)
Primary Completion Date
January 2018 (Actual)
Study Completion Date
January 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Ohio State University

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The effect of teledermatology on length of hospital admission, length of stay, 30 day readmission rate, and antibiotic use in patients presenting with cellulitis vs pseudocellulitis in an academic emergency department setting.
Detailed Description
The Investigator hope to determine if the implementation of teledermatology in the emergency department (ED) at The Ohio State University Wexner Medical Center is beneficial in diagnosing cases of cellulitis and pseudocellulitis conditions. Prior studies have indicated that misdiagnosis may occur in up to 28% of patients in the ED with these conditions. Additionally, dermatological consults have been shown to change diagnosis or management of these conditions in more than 60% of the patients examined. Without the use of teledermatology, however, a dermatological consult would be prohibitively expensive and take time to obtain. The investigator proposes that by utilizing teledermatology in emergency rooms, the investigator can make faster, yet just as accurate, dermatological diagnoses in patients presenting with cellulitis-like symptoms. Subsequently, by reducing the number of misdiagnoses, unnecessary use of antibiotics and hospitalizations will also decrease, lowering health care costs and simultaneously providing patients with faster treatment of the actual dermatologic condition.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cellulitis

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Teledermatology consult
Arm Type
Other
Arm Description
To determine the benefit of teledermatology to differentiate cellulitis from pseudocellulitis in emergency departments through the analysis of time spent in the emergency department (ED), admission to the inpatient hospital, antibiotic use, time to improvement, and 30-day remission rate. This arm will undergo imaging, a dermatologic assessment will be performed, AND this assessment will be entered into the patients chart.
Arm Title
Routine Care
Arm Type
Other
Arm Description
To determine the benefit of teledermatology to differentiate cellulitis from pseudocellulitis in emergency departments through the analysis of time spent in the emergency department (ED), admission to the inpatient hospital, antibiotic use, time to improvement, and 30-day remission rate. This arm will undergo imaging, a dermatologic assessment will be performed, AND this assessment WILL NOT be entered into the patients chart
Intervention Type
Other
Intervention Name(s)
teledermatology consult
Intervention Description
Information from the dermatologic assessment will be entered into the patients chart.
Intervention Type
Other
Intervention Name(s)
Routine Care
Intervention Description
The dermatologic assessment will occur but not added to the patients medical record. Dermatology may still be consulted but will be at the prerogative of the treating hospitalist.
Primary Outcome Measure Information:
Title
Admission to the hospital
Description
To determine the benefit of teledermatology to differentiate cellulitis from pseudocellulitis in emergency departments through the analysis of time spent in the emergency department (ED), admission to the inpatient hospital, antibiotic use, time to improvement, We anticipate a high rate of pseudocellulitis, and this aim will determine if there is a difference in patient admissions among those who receive a dermatologic assessment
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Length of stay in the hospital
Description
Will assess time spent in the hospital for those that were admitted
Time Frame
30 days post admission
Title
30 day readmission rate
Description
Will assess hospitalization/emergency department readmission in the following 30 days
Time Frame
30 days post admission
Title
Antibiotic use
Description
Will assess the frequency of antibiotic use between groups
Time Frame
30 days post admission

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Over 18 Present to the ED with cellulitis-like symptoms, including but not limited to the following: tenderness, redness, swelling, expansive lesion Exclusion Criteria: pregnant prisoner
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Benjamin H Kaffenberger, MD
Organizational Affiliation
OSU Dermatology
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Ohio State University Wexner Medical Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes

Learn more about this trial

Effect of Teledermatology on Length of Hospital Admission, Length of Stay, 30 Day Readmission Rate, and Antibiotic Use in Patients Presenting With Cellulitis vs Pseudocellulitis in an Academic ED Setting

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