ArticleBMJ open2019
User-centred clinical decision support to implement emergency department-initiated buprenorphine for opioid use disorder: protocol for the pragmatic group randomised EMBED trial.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03658642 (Pragmatic Trial of User-centered Clinical Decision Support to Implement EMergency Department-initiated BuprenorphinE for Opioid Use Disorder), which is not on this map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Pragmatic Trial of User-centered Clinical Decision Support to Implement EMergency Department-initiated BuprenorphinE for Opioid Use Disorder
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Decision-support tools via mobile devices to improve quality of care in primary healthcare settings.The Cochrane database of systematic reviews · 2021Pooled it
- Adoption of Emergency Department-Initiated Buprenorphine for Patients With Opioid Use Disorder: Secondary Analysis of a Cluster Randomized Trial.JAMA network open · 2023Trial
- User centered clinical decision support to implement initiation of buprenorphine for opioid use disorder in the emergency department: EMBED pragmatic cluster randomized controlled trial.BMJ (Clinical research ed.) · 2022Trial
- Racial, ethnic, and sex disparities in buprenorphine treatment from emergency departments by discharge diagnosis.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- Identifying emergency department patients at high risk for opioid overdose using natural language processing and machine learning.Journal of substance use and addiction treatment · 2025Article
- "The hardest part of what we're doing": research staff perspectives on engaging marginalized populations in substance use trials.Substance abuse treatment, prevention, and policy · 2025Article
- Monitoring in pragmatic trials lessons from the NIH pragmatic trials collaboratory.Contemporary clinical trials · 2025Article
- Article
- A pragmatic parallel cluster-randomized trial to evaluate the implementation and effectiveness of optimized electronic monitors in improving tuberculosis patients' treatment adherence in China: study protocol.Frontiers in public health · 2025Article
- Racial and ethnic disparities in emergency department-initiated buprenorphine across five health care systems.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
- Implementation strategies to address the determinants of adoption, implementation, and maintenance of a clinical decision support tool for emergency department buprenorphine initiation: a qualitative study.Implementation science communications · 2023Article
- Pragmatic clinical trial design in emergency medicine: Study considerations and design types.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2022Article
- Pharmacogenomic Clinical Decision Support: A Review, How-to Guide, and Future Vision.Clinical pharmacology and therapeutics · 2022Review
- Ethical and epistemic issues in the design and conduct of pragmatic stepped-wedge cluster randomized clinical trials.Contemporary clinical trials · 2022Article
- Enhancing the use of EHR systems for pragmatic embedded research: lessons from the NIH Health Care Systems Research Collaboratory.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Emergency department-based efforts to offer medication treatment for opioid use disorder: What can we learn from current approaches?Journal of substance abuse treatment · 2021Review
- Advancing emergency department-initiated buprenorphine.Journal of the American College of Emergency Physicians open · 2021Article
- Accounting for quality improvement during the conduct of embedded pragmatic clinical trials within healthcare systems: NIH Collaboratory case studies.Healthcare (Amsterdam, Netherlands) · 2021Article
- Leveraging a health information exchange to examine the accuracy of self-report emergency department utilization data among hospitalized injury survivors.Trauma surgery & acute care open · 2021Article
- Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US.JAMA internal medicine · 2020Observational
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
introductionThe goal of this trial is to determine whether implementation of a user-centred clinical decision support (CDS) system can increase adoption of initiation of buprenorphine (BUP) into the routine emergency care of individuals with opioid use disorder (OUD).
methodsA pragmatic cluster randomised trial is planned to be carried out in 20 emergency departments (EDs) across five healthcare systems over 18 months. The intervention consists of a user-centred CDS integrated into ED clinician electronic workflow and available for guidance to: (1) determine whether patients presenting to the ED meet criteria for OUD, (2) assess withdrawal symptoms and (3) ascertain and motivate patient willingness to initiate treatment. The CDS guides the ED clinician to initiate BUP and facilitate follow-up. The primary outcome is the rate of BUP initiated in the ED. Secondary outcomes are: (1) rates of receiving a referral, (2) fidelity with the CDS and (3) rates of clinicians providing any ED-initiated BUP, referral for ongoing treatment and receiving Drug Addiction Act of 2000 training. Primary and secondary outcomes will be analysed using generalised linear mixed models, with fixed effects for intervention status (CDS vs usual care), prespecified site and patient characteristics, and random effects for study site. ETHICS AND DISSEMINATION: The protocol has been approved by the Western Institutional Review Board. No identifiable private information will be collected from patients. A waiver of informed consent was obtained for the collection of data for clinician prescribing and other activities. As a minimal risk implementation study of established best practices, an Independent Study Monitor will be utilised in place of a Data Safety Monitoring Board. Results will be reported in ClinicalTrials.gov and published in open-access, peer-reviewed journals, presented at national meetings and shared with the clinicians at participating sites via a broadcast email notification of publications. TRIAL REGISTRATION NUMBER: NCT03658642; Pre-results.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.