Evidence Based Decision Making: Integrating Clinical Prediction Rules into Electr
Project Number5R18HS018491-04
Contact PI/Project LeaderMCGINN, THOMAS G
Awardee OrganizationFEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
Description
Abstract Text
DESCRIPTION (provided by applicant): Clinical prediction rules (CPRs) are frontline decision aids that help physicians make evidence-based, cost effective decisions that benefit their patients. CPRs are proven tools that translate evidence into practice, increase quality while reducing costs, and can be used by physicians in a wide variety of clinical settings, such as primary care offices, emergency rooms, and hospitals. While many CPRs have been developed and validated over the years, health care providers have yet to incorporate them into everyday care. CPRs aid providers in assessing the impact of individual components of a patient's history, physical examination, and basic lab results to estimate probability of disease or potential response to a treatment. Prediction rules use data that is readily available at the time of a patient encounter and often reduce unnecessary treatments and diagnostic testing. CPRs differ from reminder systems or alerts in that CPRs pull in aspects of the history and physical exam and in an evidence based fashion estimate probabilities, prognosis,
or make treatment recommendations. The goal of this study is to utilize patient electronic health records to incorporate CPRs into the face-to-face patient encounter. We propose to select certain clinical situations where well-validated CPRs are available and likely to be needed on a frequent basis. We will randomly assign an integrated CPR versus usual care into the point of care and evaluate the impact of this integration on doctor behavior and evidence-based decision making. Mount Sinai's Division of General Internal Medicine (DGIM) has significant experience with all aspects of CPRs, including derivation, validation, implementation, and systematic review. Furthermore, the Division has developed an interactive web library of CPRs for clinical use that is one of the most widely sites of its kind. We
propose to collaborate with Epic, one of the nation's largest and most respected electronic medical record (EMR) companies, to integrate validated CPRs into EMRs and assess the impact on provider behavior and patient care.
Public Health Relevance Statement
Project Narrative
Clinical prediction rules (CPRs) are frontline decision aids that help physicians make evidence-based, cost-
effective decisions that benefit their patients. The aims of this project are to incorporate two well validated
CPRs (Streptococcal Pharyngitis Prediction Rule and the Pneumonia Clinical Prediction Rule) into an
outpatient Electronic Medical Record System (EMR) and to perform a randomized controlled trial of the
effectivenss of integrated CPRs impact on doctor's behaviors (e.g. test ordering and medication prescribing).
No Sub Projects information available for 5R18HS018491-04
Publications
Publications are associated with projects, but cannot be identified with any particular year of the project or fiscal year of funding. This is due to the continuous and cumulative nature of knowledge generation across the life of a project and the sometimes long and variable publishing timeline. Similarly, for multi-component projects, publications are associated with the parent core project and not with individual sub-projects.
No Publications available for 5R18HS018491-04
Patents
No Patents information available for 5R18HS018491-04
Outcomes
The Project Outcomes shown here are displayed verbatim as submitted by the Principal Investigator (PI) for this award. Any opinions, findings, and conclusions or recommendations expressed are those of the PI and do not necessarily reflect the views of the National Institutes of Health. NIH has not endorsed the content below.
No Outcomes available for 5R18HS018491-04
Clinical Studies
No Clinical Studies information available for 5R18HS018491-04
News and More
Related News Releases
No news release information available for 5R18HS018491-04
History
No Historical information available for 5R18HS018491-04
Similar Projects
No Similar Projects information available for 5R18HS018491-04