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CT C-spine Audit and Feedback

Primary Purpose

Cervical Spine Injury, Emergencies, Trauma

Status

Active

Phase

Not Applicable

Locations

United States

Study Type

Interventional

Intervention

Audit and Feedback on Individual Practice Patterns

About this trial

This is an interventional health services research trial for Cervical Spine Injury focused on measuring computed tomography, resource utilization, NEXUS, emergency medicine

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: 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 Exclusion Criteria: Non-emergency providers Ordered few than 5 studies in the pre-intervention period

Sites / Locations

University of Massachusetts Chan Medical School

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

No Intervention

Arm Label

Serial In-Person Feedback

In-Person Feedback with Serial Electronic Feedback

Control

Arm Description

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

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

Providers are not given any feedback on their practice patterns.

Outcomes

Primary Outcome Measures

Percent NEXUS-Negative

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

Secondary Outcome Measures

Number of Fractures

Number of cervical spine fractures identified on CT for patients who are NEXUS-negative

Clinically Significant Fractures

Number of cervical spine fractures identified on CT for patients who are NEXUS-negative that required procedural intervention, hospitalization, or prolonged immobilization

Number of CTs

Number of CT scans of the cervical spine ordered by each provider

Full Information

NCT ID

NCT05711134

First Posted

January 24, 2023

Last Updated

January 24, 2023

Sponsor

University of Massachusetts, Worcester

1. Study Identification

Unique Protocol Identification Number

NCT05711134

Brief Title

CT C-spine Audit and Feedback

Official Title

Audit and Feedback for Computed Tomography of the Cervical Spine in the Emergency Department

Study Type

Interventional

2. Study Status

Record Verification Date

January 2023

Overall Recruitment Status

Active, not recruiting

Study Start Date

January 1, 2023 (Actual)

Primary Completion Date

July 31, 2023 (Anticipated)

Study Completion Date

July 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title

Principal Investigator

Name of the Sponsor

University of Massachusetts, Worcester

4. Oversight

Studies a U.S. FDA-regulated Drug Product

Studies a U.S. FDA-regulated Device Product

Data Monitoring Committee

5. Study Description

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. We 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.

6. Conditions and Keywords

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

Cervical Spine Injury, Emergencies, Trauma

Keywords

computed tomography, resource utilization, NEXUS, emergency medicine

7. Study Design

Primary Purpose

Health Services Research

Study Phase

Not Applicable

Interventional Study Model

Parallel Assignment

Masking

ParticipantCare Provider

Allocation

Randomized

Enrollment

90 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title

Serial In-Person Feedback

Arm Type

Experimental

Arm Description

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

Arm Title

In-Person Feedback with Serial Electronic Feedback

Arm Type

Experimental

Arm Description

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

Arm Title

Control

Arm Type

No Intervention

Arm Description

Providers are not given any feedback on their practice patterns.

Intervention Type

Behavioral

Intervention Name(s)

Audit and Feedback on Individual Practice Patterns

Intervention Description

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

Primary Outcome Measure Information:

Title

Percent NEXUS-Negative

Description

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

Time Frame

6 months

Secondary Outcome Measure Information:

Title

Number of Fractures

Description

Number of cervical spine fractures identified on CT for patients who are NEXUS-negative

Time Frame

6 months

Title

Clinically Significant Fractures

Description

Number of cervical spine fractures identified on CT for patients who are NEXUS-negative that required procedural intervention, hospitalization, or prolonged immobilization

Time Frame

6 months

Title

Number of CTs

Description

Number of CT scans of the cervical spine ordered by each provider

Time Frame

6 months

10. Eligibility

Sex

All

Accepts Healthy Volunteers

Eligibility Criteria

Facility Information:

Facility Name

University of Massachusetts Chan Medical School

City

Worcester

State/Province

Massachusetts

ZIP/Postal Code

01655

Country

United States

12. IPD Sharing Statement

Plan to Share IPD

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CT C-spine Audit and Feedback

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