Evidence map›Paper›PMID 39103955›Full record

ArticleImplementation science : IS2024

A pragmatic, stepped-wedge, hybrid type II trial of interoperable clinical decision support to improve venous thromboembolism prophylaxis for patients with traumatic brain injury.

Christopher J Tignanelli, Surbhi Shah, David Vock, Lianne Siegel, Carlos Serrano, Elliott Haut, Sean Switzer, Christie L Martin, Rubina Rizvi, Vincent Peta and 9 more

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

Article in Implementation science : IS, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05628207 (Evaluation of the SCALED), 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.

NCT05628207 recruitingnot on this map

Evaluation of the SCALED (SCaling AcceptabLE cDs) Approach for the Implementation of Interoperable CDS for Venous Thromboembolism Prevention - CDS Data

TypeobservationalSponsorUniversity of MinnesotaRan2023 to 2026Enrolled15,000ConditionsTraumatic Brain Injury, Venous ThromboembolismArmsObservational, Observational-control
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
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

19 authors.

Christopher J TignanelliDepartment of Surgery, University of Minnesota, 420 Delaware St SE, MMC 195, Minneapolis, MN, 55455, USA. ctignane@umn.edu.ORCID 0000-0002-8079-5565
Surbhi ShahDepartment of Medicine, Mayo Clinic, Scottsdale, AZ, USA.
David VockDivision of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN, USA.
Lianne SiegelDivision of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN, USA.
Carlos SerranoDivision of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN, USA.
Elliott HautDepartment of Surgery, Johns Hopkins University, Baltimore, MD, USA.
Sean SwitzerM Health Fairview, Minneapolis, MN, USA.
Christie L MartinSchool of Nursing, University of Minnesota, Minneapolis, MN, USA.
Rubina RizviInstitute for Health Informatics, University of Minnesota, Minneapolis, MN, USA.
Vincent PetaDepartment of Surgery, University of Minnesota, 420 Delaware St SE, MMC 195, Minneapolis, MN, 55455, USA.
Peter C JenkinsDepartment of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
Nicholas LemkeDepartment of Surgery, University of Minnesota, 420 Delaware St SE, MMC 195, Minneapolis, MN, 55455, USA.
Thankam ThyvalikakathCenter for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, USA.
Jerome A OsheroffTMIT Consulting, LLC, Naples, FL, USA.
Denise TorresDepartment of Surgery, Geisinger Health, Danville, PA, USA.
David VawdreyDepartment of Biomedical Informatics, Geisinger Health, Danville, PA, USA.
Rachael A CallcutDepartment of Surgery, UC Davis School of Medicine, Sacramento, CA, USA.
Mary ButlerCenter for Learning Health Systems Science, University of Minnesota, Minneapolis, MN, USA.
Genevieve B MeltonDepartment of Surgery, University of Minnesota, 420 Delaware St SE, MMC 195, Minneapolis, MN, 55455, USA.

Funding

Evaluation of the SCALED (SCaling AcceptabLE cDs) Approach for the Implementation of Interoperable CDS for Venous Thromboembolism PreventionR18HS028583 · AHRQ · UNIVERSITY OF MINNESOTA · PI MELTON-MEAUX, GENEVIEVE B, TIGNANELLI, CHRISTOPHER J · 2022 to 2024
$2.9M
Agency for Healthcare Research and Quality Safety Program for Telemedicine R18HS028583AHRQ HHS R18 HS028583
6 · The paper itself

Abstract

backgroundVenous thromboembolism (VTE) is a preventable medical condition which has substantial impact on patient morbidity, mortality, and disability. Unfortunately, adherence to the published best practices for VTE prevention, based on patient centered outcomes research (PCOR), is highly variable across U.S. hospitals, which represents a gap between current evidence and clinical practice leading to adverse patient outcomes. This gap is especially large in the case of traumatic brain injury (TBI), where reluctance to initiate VTE prevention due to concerns for potentially increasing the rates of intracranial bleeding drives poor rates of VTE prophylaxis. This is despite research which has shown early initiation of VTE prophylaxis to be safe in TBI without increased risk of delayed neurosurgical intervention or death. Clinical decision support (CDS) is an indispensable solution to close this practice gap; however, design and implementation barriers hinder CDS adoption and successful scaling across health systems. Clinical practice guidelines (CPGs) informed by PCOR evidence can be deployed using CDS systems to improve the evidence to practice gap. In the Scaling AcceptabLE cDs (SCALED) study, we will implement a VTE prevention CPG within an interoperable CDS system and evaluate both CPG effectiveness (improved clinical outcomes) and CDS implementation.

methodsThe SCALED trial is a hybrid type 2 randomized stepped wedge effectiveness-implementation trial to scale the CDS across 4 heterogeneous healthcare systems. Trial outcomes will be assessed using the RE DISCUSSION: The stepped wedge hybrid type 2 trial will provide evidence regarding the effectiveness of CDS based on the Berne-Norwood criteria for VTE prevention in patients with TBI. Additionally, it will provide evidence regarding a successful strategy to scale interoperable CDS systems across U.S. healthcare systems, advancing both the fields of implementation science and health informatics.

trial registrationClinicaltrials.gov - NCT05628207. Prospectively registered 11/28/2022, https://classic. CLINICALTRIALS: gov/ct2/show/NCT05628207 .

Indexed as

Brain Injuries, TraumaticDecision Support Systems, ClinicalVenous ThromboembolismGuideline AdherenceHumansImplementation SciencePractice Guidelines as TopicPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicClinical decision supportHealth informaticsImplementation scienceLearning health systemMixed methodsProphylaxisRandomized controlled trialStepped wedgeTraumatic brain injuryVenous thromboembolism

Identifiers

PMID39103955
PMCPMC11299263

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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.