行为助推对采用电子健康记录无关的肺栓塞风险预测工具的影响：一项试点整群非随机对照试验。
Effect of a behavioral nudge on adoption of an electronic health record-agnostic pulmonary embolism risk prediction tool: a pilot cluster nonrandomized controlled trial.
作者信息
Richardson Safiya, Dauber-Decker Katherine L, Solomon Jeffrey, Seelamneni Pradeep, Khan Sundas, Barnaby Douglas P, Chelico John, Qiu Michael, Liu Yan, Sanghani Shreya, Izard Stephanie M, Chiuzan Codruta, Mann Devin, Pekmezaris Renee, McGinn Thomas, Diefenbach Michael A
机构信息
New York University (NYU) Langone, New York, NY 10016, United States.
Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030, United States.
出版信息
JAMIA Open. 2024 Aug 1;7(3):ooae064. doi: 10.1093/jamiaopen/ooae064. eCollection 2024 Oct.
OBJECTIVE
Our objective was to determine the feasibility and preliminary efficacy of a behavioral nudge on adoption of a clinical decision support (CDS) tool.
MATERIALS AND METHODS
We conducted a pilot cluster nonrandomized controlled trial in 2 Emergency Departments (EDs) at a large academic healthcare system in the New York metropolitan area. We tested 2 versions of a CDS tool for pulmonary embolism (PE) risk assessment developed on a web-based electronic health record-agnostic platform. One version included behavioral nudges incorporated into the user interface.
RESULTS
A total of 1527 patient encounters were included in the trial. The CDS tool adoption rate was 31.67%. Adoption was significantly higher for the tool that included behavioral nudges (39.11% vs 20.66%; < .001).
DISCUSSION
We demonstrated feasibility and preliminary efficacy of a PE risk prediction CDS tool developed using insights from behavioral science. The tool is well-positioned to be tested in a large randomized clinical trial.
TRIAL REGISTRATION
Clinicaltrials.gov (NCT05203185).
目的
我们的目的是确定行为助推对临床决策支持（CDS）工具采用情况的可行性和初步疗效。
材料与方法
我们在纽约大都市地区一个大型学术医疗系统的2个急诊科进行了一项试点整群非随机对照试验。我们测试了在基于网络的与电子健康记录无关的平台上开发的2个用于肺栓塞（PE）风险评估的CDS工具版本。其中一个版本在用户界面中纳入了行为助推。
结果
试验共纳入1527次患者诊疗。CDS工具的采用率为31.67%。包含行为助推的工具的采用率显著更高（39.11%对20.66%；P<0.001）。
讨论
我们证明了利用行为科学见解开发的PE风险预测CDS工具的可行性和初步疗效。该工具很适合在大型随机临床试验中进行测试。
试验注册
Clinicaltrials.gov（NCT05203185）。
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