ArticleMedical care2015
Eliminating Health Care Disparities With Mandatory Clinical Decision Support: The Venous Thromboembolism (VTE) Example.
Article in Medical care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
47 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and unintended consequences of hard-stop alerts in electronic health record systems: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2018Pooled it
- Trial
- Alert-Triggered Patient Education Versus Nurse Feedback for Nonadministered Venous Thromboembolism Prophylaxis Doses: A Cluster-Randomized Controlled Trial.Journal of the American Heart Association · 2022Trial
- Computerized Clinical Decision Support System for Prompting Brief Alcohol Interventions with Treatment Seeking Smokers: A Sex-Based Secondary Analysis of a Cluster Randomized Trial.International journal of environmental research and public health · 2020Trial
- Trial
- Prescriber knowledge and attitudes regarding non-administration of prescribed pharmacologic venous thromboembolism prophylaxis.Journal of thrombosis and thrombolysis · 2016Trial
- Implementation and Evaluation of a Best Practice Advisory to Reduce Inequities in Technology Use for People With Type 1 Diabetes: Protocol for a Mixed Methods, Nonrandomized Controlled Trial.JMIR research protocols · 2025Article
- The relation between socioeconomic status and invasive haemodynamics at evaluation for advanced heart failure.ESC heart failure · 2025Article
- Mitigation of Racial and Ethnic Differences in Chlamydia and Gonorrhea Testing.Pediatrics open science · 2025Article
- Factors associated with venous thromboembolism pharmacoprophylaxis initiation in hospitalized medical patients: the Medical Inpatients Thrombosis and Hemostasis study.Journal of thrombosis and haemostasis : JTH · 2024Article
- Enhancing neuro-oncology care through equity-driven applications of artificial intelligence.Neuro-oncology · 2024Review
- Differences in quality of anticoagulation care delivery according to ethnoracial group in the United States: A scoping review.Journal of thrombosis and thrombolysis · 2024Article
- Racial Disparities in Bowel Preparation and Post-Operative Outcomes in Colorectal Cancer Patients.Healthcare (Basel, Switzerland) · 2024Article
- Venous thromboembolism prophylaxis usage among surgical patients in both private and public hospitals in Ethiopia.Heliyon · 2024Article
- Impact of Clinical Decision Support with Mandatory versus Voluntary Venous Thromboembolism Risk Assessment in Hospitalized Patients.TH open : companion journal to thrombosis and haemostasis · 2024Article
- Patient Characteristics, Management, and Outcomes in a Novel Cohort of Primary Hyperparathyroidism.Journal of the Endocrine Society · 2024Article
- Racial and Ethnic Disparities in the Diagnosis and Treatment of Thyroid Disease.The Journal of clinical endocrinology and metabolism · 2024Review
- Effects of Sociodemographic Factors on Access to and Outcomes in Congenital Heart Disease in the United States.Journal of cardiovascular development and disease · 2024Article
- A bibliometric analysis in venous thromboembolism nursing (1999-2022): Current status and future prospects.Heliyon · 2024Article
- Implementation of a novel daily performance improvement checklist (PIC) improves alcohol screening and intervention compliance in trauma.Trauma surgery & acute care open · 2024Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundAll hospitalized patients should be assessed for venous thromboembolism (VTE) risk factors and prescribed appropriate prophylaxis. To improve best-practice VTE prophylaxis prescription for all hospitalized patients, we implemented a mandatory computerized clinical decision support (CCDS) tool. The tool requires completion of checklists to evaluate VTE risk factors and contraindications to pharmacological prophylaxis, and then recommends the risk-appropriate VTE prophylaxis regimen.
objectivesThe objective of the study was to examine the effect of a quality improvement intervention on race-based and sex-based health care disparities across 2 distinct clinical services. RESEARCH
designThis was a retrospective cohort study of a quality improvement intervention. SUBJECTS: The study included 1942 hospitalized medical patients and 1599 hospitalized adult trauma patients. MEASURES: In this study, the proportion of patients prescribed risk-appropriate, best-practice VTE prophylaxis was evaluated.
resultsRacial disparities existed in prescription of best-practice VTE prophylaxis in the preimplementation period between black and white patients on both the trauma (70.1% vs. 56.6%, P=0.025) and medicine (69.5% vs. 61.7%, P=0.015) services. After implementation of the CCDS tool, compliance improved for all patients, and disparities in best-practice prophylaxis prescription between black and white patients were eliminated on both services: trauma (84.5% vs. 85.5%, P=0.99) and medicine (91.8% vs. 88.0%, P=0.082). Similar findings were noted for sex disparities in the trauma cohort.
conclusionsDespite the fact that risk-appropriate prophylaxis should be prescribed equally to all hospitalized patients regardless of race and sex, practice varied widely before our quality improvement intervention. Our CCDS tool eliminated racial disparities in VTE prophylaxis prescription across 2 distinct clinical services. Health information technology approaches to care standardization are effective to eliminate health care disparities.
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