ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Coronavirus Disease 2019 (COVID-19) Diagnostic Clinical Decision Support: A Pre-Post Implementation Study of CORAL (COvid Risk cALculator).
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 17 citations in OpenAlex.
- Integrating Radiology & Clinical Decision Support to Drive Management of Emergency Department Patients in a Large Academic Medical Center.Journal of imaging informatics in medicine · 2026Article
- Don't know much about geography? Decision support for the evaluation of patients with suspected high consequence infectious diseases.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Separating the rash from the chaff: novel clinical decision support deployed during the mpox outbreak.Infection control and hospital epidemiology · 2024Article
- Handheld Lung Ultrasound to Detect COVID-19 Pneumonia in Inpatients: A Prospective Cohort Study.POCUS journal · 2023Article
- Relative bed allocation for COVID-19 patients, EHR investments, and COVID-19 mortality outcomes.PloS one · 2023Article
- Development and implementation of a clinical decision support system tool for the evaluation of suspected monkeypox infection.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- A scoping review of knowledge authoring tools used for developing computerized clinical decision support systems.JAMIA open · 2021Article
- Yield of Severe Acute Respiratory Syndrome Coronavirus 2 Lower Respiratory Tract Testing After a Negative Nasopharyngeal Test Among Hospitalized Persons Under Investigation for Coronavirus Disease 2019.Open forum infectious diseases · 2021Article
- Reducing Morbidity and Mortality Rates from COVID-19, Influenza and Pneumococcal Illness in Nursing Homes and Long-Term Care Facilities by Vaccination and Comprehensive Infection Control Interventions.Geriatrics (Basel, Switzerland) · 2021Article
Corrections and comments
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Authors and funding
28 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundIsolation of hospitalized persons under investigation (PUIs) for coronavirus disease 2019 (COVID-19) reduces nosocomial transmission risk. Efficient evaluation of PUIs is needed to preserve scarce healthcare resources. We describe the development, implementation, and outcomes of an inpatient diagnostic algorithm and clinical decision support system (CDSS) to evaluate PUIs.
methodsWe conducted a pre-post study of CORAL (COvid Risk cALculator), a CDSS that guides frontline clinicians through a risk-stratified COVID-19 diagnostic workup, removes transmission-based precautions when workup is complete and negative, and triages complex cases to infectious diseases (ID) physician review. Before CORAL, ID physicians reviewed all PUI records to guide workup and precautions. After CORAL, frontline clinicians evaluated PUIs directly using CORAL. We compared pre- and post-CORAL frequency of repeated severe acute respiratory syndrome coronavirus 2 nucleic acid amplification tests (NAATs), time from NAAT result to PUI status discontinuation, total duration of PUI status, and ID physician work hours, using linear and logistic regression, adjusted for COVID-19 incidence.
resultsFewer PUIs underwent repeated testing after an initial negative NAAT after CORAL than before CORAL (54% vs 67%, respectively; adjusted odd ratio, 0.53 [95% confidence interval, .44-.63]; P < .01). CORAL significantly reduced average time to PUI status discontinuation (adjusted difference [standard error], -7.4 [0.8] hours per patient), total duration of PUI status (-19.5 [1.9] hours per patient), and average ID physician work-hours (-57.4 [2.0] hours per day) (all P < .01). No patients had a positive NAAT result within 7 days after discontinuation of precautions via CORAL.
conclusionsCORAL is an efficient and effective CDSS to guide frontline clinicians through the diagnostic evaluation of PUIs and safe discontinuation of precautions.
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