ArticleJAMIA open2026
Development to implementation to evaluation: step-by-step approach to embedding a clinical trial of a machine learning algorithm in the electronic health record.
Article in JAMIA open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
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0 citing papers in PubMed.
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Authors and funding
5 authors.
Funding
Abstract
Objective: To describe the implementation process for the Precision Resuscitation with Crystalloids in Sepsis (PRECISE) trial, a pragmatic, multihospital randomized controlled trial (RCT) of a machine learning (ML) algorithm integrated into the electronic health record (EHR). Materials and Methods: Implementing PRECISE involved building 4 key components into the EHR using standard tools within Epic: (1) automated inclusion criteria, (2) real-time subphenotyping. (3) randomization, and (4) medication alternative alert. Results: The PRECISE trial was deployed across 6 Emory Healthcare hospitals in June 2024, spanning 6 emergency departments and 17 ICUs with more than 300 ICU beds. Discussion and Conclusion: PRECISE operationalizes an ML algorithm within the Epic to identify a subgroup of sepsis patients and prompts the clinician to order the type of fluids thought to confer a mortality benefit in this subgroup. PRECISE demonstrates that precision RCTs of ML algorithms can be executed entirely within the EHR, a framework that represents a model for future learning health systems.
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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.