CT C-spine Audit and Feedback

Sponsor

University of Massachusetts, Worcester (Other)

Overall Status

Active, not recruiting

CT.gov ID

NCT05711134

Collaborator

(none)

Enrollment

Location

Arms

6.9

Anticipated Duration (Months)

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

This is a prospective quality improvement study to assess the effect of using an audit-and-feedback process for emergency providers on utilization of computed tomography of the cervical spine. The objective of this study is to determine whether providing repeated individualized feedback on CT C-spine utilization to emergency providers alters their practice pattern and reduces overutilization. We hypothesize that emergency providers who receive individualized feedback regarding their CT C-spine utilization on a regular basis will alter their practice pattern to reduce overutilization of this imaging study.

Condition or Disease	Intervention/Treatment	Phase
Cervical Spine Injury Emergencies Trauma	Behavioral: Audit and Feedback on Individual Practice Patterns	N/A

Study Design

Study Type:

Interventional

Anticipated Enrollment :

90 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

Double (Participant, Care Provider)

Primary Purpose:

Health Services Research

Official Title:

Audit and Feedback for Computed Tomography of the Cervical Spine in the Emergency Department

Actual Study Start Date :

Jan 1, 2023

Anticipated Primary Completion Date :

Jul 31, 2023

Anticipated Study Completion Date :

Jul 31, 2023

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Serial In-Person Feedback Providers are given recurring individualized in-person feedback on their practice patterns.	Behavioral: Audit and Feedback on Individual Practice Patterns Providers are given feedback on their practice patterns of ordering computed tomography of the cervical spine.
Experimental: In-Person Feedback with Serial Electronic Feedback Providers are given one-time individualized in-person feedback on their practice patterns, followed by recurrent individualized electronic feedback.	Behavioral: Audit and Feedback on Individual Practice Patterns Providers are given feedback on their practice patterns of ordering computed tomography of the cervical spine.
No Intervention: Control Providers are not given any feedback on their practice patterns.

Arm

Intervention/Treatment

Experimental: Serial In-Person Feedback

Providers are given recurring individualized in-person feedback on their practice patterns.

Behavioral: Audit and Feedback on Individual Practice Patterns

Providers are given feedback on their practice patterns of ordering computed tomography of the cervical spine.

Experimental: In-Person Feedback with Serial Electronic Feedback

Providers are given one-time individualized in-person feedback on their practice patterns, followed by recurrent individualized electronic feedback.

Behavioral: Audit and Feedback on Individual Practice Patterns

Providers are given feedback on their practice patterns of ordering computed tomography of the cervical spine.

No Intervention: Control

Providers are not given any feedback on their practice patterns.

Outcome Measures

Primary Outcome Measures

Percent NEXUS-Negative [6 months]
Percentage of CT C-spine studies that an individual provider ordered on NEXUS-negative patients

Secondary Outcome Measures

Number of Fractures [6 months]
Number of cervical spine fractures identified on CT for patients who are NEXUS-negative
Clinically Significant Fractures [6 months]
Number of cervical spine fractures identified on CT for patients who are NEXUS-negative that required procedural intervention, hospitalization, or prolonged immobilization
Number of CTs [6 months]
Number of CT scans of the cervical spine ordered by each provider

Eligibility Criteria

Criteria

Ages Eligible for Study:

N/A and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Emergency medicine physician, nurse practitioner, or physician assistant
Ordered at least 5 CT scans of the cervical spine on adult patients in the two-month pre-intervention period

Exclusion Criteria:

Non-emergency providers
Ordered few than 5 studies in the pre-intervention period

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	University of Massachusetts Chan Medical School	Worcester	Massachusetts	United States	01655

Sponsors and Collaborators

University of Massachusetts, Worcester

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

Responsible Party:

Karl Chamberlin, Clinical Instructor, University of Massachusetts, Worcester

ClinicalTrials.gov Identifier:

NCT05711134

Other Study ID Numbers:

STUDY00000533

First Posted:

Feb 2, 2023

Last Update Posted:

Feb 2, 2023

Last Verified:

Jan 1, 2023

Individual Participant Data (IPD) Sharing Statement:

Plan to Share IPD:

Studies a U.S. FDA-regulated Drug Product:

Studies a U.S. FDA-regulated Device Product:

Keywords provided by Karl Chamberlin, Clinical Instructor, University of Massachusetts, Worcester

Additional relevant MeSH terms:

Emergencies

Spinal Injuries

Study Results

No Results Posted as of Feb 2, 2023