Evidence map›Paper›PMID 37158929›Full record

ArticleTrials2023

General improvements versus interruptive or non-interruptive alerts in the blood order set: study protocol for a randomized control trial to improve packed red blood cell utilization.

Neelam Mistry, Vanessa Richardson, Evan Carey, Samuel Porter, Sharon Pincus, Sylvie Novins-Montague, Megan Elmer, Chen-Tan Lin, P Michael Ho, Tyler Anstett

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04823273 (Blood Transfusion Reduction Quality Improvement Project), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT04823273 nacompletednot on this map

Blood Transfusion Reduction Quality Improvement Project

TypeinterventionalSponsorUniversity of Colorado, DenverRan2021 to 2022Enrolled1,640ConditionsBlood TransfusionArmsGeneral improvement, In-line help text, Interruptive alert
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Neelam MistryDivision of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, 12401 East 17Th Avenue, Mailstop F-782, Aurora, CO, 80045, USA. neelam.mistry@cuanschutz.edu.
Vanessa RichardsonDepartment of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Evan CareyDepartment of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Samuel PorterDivision of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, 12401 East 17Th Avenue, Mailstop F-782, Aurora, CO, 80045, USA.
Sharon PincusThe NavLab, an Adult and Child Consortium of Outcome Research and Delivery Science (ACCORDS) Program, University of Colorado School of Medicine, Aurora, CO, USA.
Sylvie Novins-MontagueThe NavLab, an Adult and Child Consortium of Outcome Research and Delivery Science (ACCORDS) Program, University of Colorado School of Medicine, Aurora, CO, USA.
Megan ElmerThe NavLab, an Adult and Child Consortium of Outcome Research and Delivery Science (ACCORDS) Program, University of Colorado School of Medicine, Aurora, CO, USA.
Chen-Tan LinDivision of Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
P Michael HoThe NavLab, an Adult and Child Consortium of Outcome Research and Delivery Science (ACCORDS) Program, University of Colorado School of Medicine, Aurora, CO, USA.
Tyler AnstettDivision of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, 12401 East 17Th Avenue, Mailstop F-782, Aurora, CO, 80045, USA.

Funding

Anschutz Medical Campus, University of Colorado Personnel support (data analytics) for this project was provided by the University of Colorado Anschutz Medical Campus School of Medicine Data Science to Patient Value Dean's Transformational Research Grant
6 · The paper itself

Abstract

backgroundBlood transfusions can serve as a life-saving treatment, but inappropriate blood product transfusions can result in patient harm and excess costs for health systems. Despite published evidence supporting restricted packed red blood cell (pRBC) usage, many providers transfuse outside of guidelines. Here, we report a novel prospective, randomized control trial to increase guideline-concordant pRBC transfusions comparing three variations of clinical decision support (CDS) in the electronic health record (EHR).

methodsAll inpatient providers at University of Colorado Hospital (UCH) who order blood transfusions were randomized in a 1:1:1 fashion to the three arms of the study: (1) general order set improvements, (2) general order set improvements plus non-interruptive in-line help text alert, and (3) general order set improvements plus interruptive alert. Transfusing providers received the same randomized order set changes for 18 months. The primary outcome of this study is the guideline-concordant rate of pRBC transfusions. The primary objective of this study is to compare the group using the new interface (arm 1) versus the two groups using the new interface with interruptive or non-interruptive alerts (arms 2 and 3, combined). The secondary objectives compare guideline-concordant transfusion rates between arm 2 and arm 3 as well as comparing all of arms of the study in aggregate to historical controls. This trial concluded after 12 months on April 5, 2022. DISCUSSION: CDS tools can increase guideline-concordant behavior. This trial will examine three different CDS tools to determine which type is most effective at increasing guideline-concordant blood transfusions.

trial registrationRegistered on ClinicalTrials.gov 3/20/21, NCT04823273 . Approved by University of Colorado Institutional Review Board (19-0918), protocol version 1 4/19/2019, approved 4/30/2019.

Indexed as

Electronic Health RecordsErythrocyte TransfusionErythrocytesEthics Committees, ResearchHumansProspective StudiesRandomized Controlled Trials as TopicBlood transfusionsClinical decision supportEvidence-based transfusionPacked red blood cellsRandomized control trialTransfusion threshold

Identifiers

PMID37158929
PMCPMC10165805

What OpenQuestion holds

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LicenceCC BY
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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.