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Trial registered on ANZCTR
Registration number
ACTRN12610000489099
Ethics application status
Approved
Date submitted
10/06/2010
Date registered
12/07/2005
Date last updated
12/07/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
Decision Support Study - A study on the impact of an evidence-based bedside electronic decision support tool on change in clinical performance in the care of Alberta hemodialysis patients
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Scientific title
A study on the impact of an evidence-based bedside electronic decision support tool on change in clinical performance in the care of Alberta hemodialysis patients
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Secondary ID [1]
975
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CRG060500005 - Cochrane Renal Group
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
hemodialyisis patients
243636
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Condition category
Condition code
Renal and Urogenital
256895
256895
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0
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A bedside decision support tool that provides patient specific, evidence-based management recommendations to rounding nephrologists responsible for each patient's medical management.
The decision support tool will consist of an electronic database containing clinical information on study subjects. A series of simple algorithms will incorporate these clinical data and the tool will generate patient-specific recommendations for clinical management every two weeks. The recommendations will be printed out on individual sheets of paper for each subject in the active treatment group and put on the clinical chart. The attending nephrologists will view the recommendations when they make their rounds.
Clinical data will also be concurrently collected and stored for subjects in a control group, however no recommendations will be generated throughout the study.
Study timeline - The electronic database will store data on both study groups an intial 6 month period but no recommendations will be generated, although rounding nephrologists will have access to the clinical data. For the following 18 months the electronically stored data will continue to be available to rounding nephrologists in both study groups, however, recommendations will be generated every two weeks for nephrologists treating the active group only.
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Intervention code [1]
255959
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Treatment: Other
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Comparator / control treatment
Medical management as per standard procedures - routine clinical care delivered to patients receiving hemodialysis. No recommendations by decision support tool will be generated for this group.
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Control group
Active
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Outcomes
Primary outcome [1]
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Improvement in:
Blood Pressure control - proportion of patients with post-dialysis systolic Blood Pressure at target (<130 mmHg).
The blood pressures are performed on the hemodialysis unit by clinical staff as part of routine care.
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Assessment method [1]
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Timepoint [1]
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1 year after intervention start
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Secondary outcome [1]
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Improvement in:
Improvement in metabolic bone disease
Calculate the mean pre-dialysis calcium, phosphate and parathyroid hormone levels
Calculate the proportion of patients with plasma calcium (2.1 - 2.5 millimoles per liter (mmol/l)), plasma phosphate (< 1.8 mmol/l) and parathyroid hormone at target (10 - 40 picomoles per liter (pmol/l))
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Assessment method [1]
257370
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Timepoint [1]
257370
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After one year of intervention start
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Secondary outcome [2]
263158
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Improvement in vascular access rates.
Calculate the proportion of patients with arteriovenous fistulae in use or maturing.
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Assessment method [2]
263158
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Timepoint [2]
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After 1 year intervention start
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Secondary outcome [3]
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Improvement in the referral for transplantation rates
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Assessment method [3]
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Timepoint [3]
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After one year of intervention start.
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Eligibility
Key inclusion criteria
Patients receiving in-center hemodialysis in Alberta
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Minimum age
18
Years
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Maximum age
100
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
None
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Clinical data will be collected on subjects receiving dialysis treatment on hemodialysis units in Edmonton and Calgary. Physicians treating subjects in Edmonton will receive recommendations generated by the study tool. Physicians treating subjects in Calgary will receive no recommendations from the study tool.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
N/A
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
N/A
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/04/2006
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
650
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
1987
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Canada
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State/province [1]
1987
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Alberta
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Funding & Sponsors
Funding source category [1]
243583
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Charities/Societies/Foundations
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Name [1]
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Alberta Heritage Foundation for Medical Research
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Address [1]
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Suite 1500,
10104 - 103 Avenue
Edmonton, Alberta
T5J 4A7
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Country [1]
243583
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Canada
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Primary sponsor type
Charities/Societies/Foundations
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Name
Alberta Heritage Foundation for Medical Research
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Address
Suite 1500,
10104 - 103 Avenue
Edmonton, Alberta
T5J 4A7
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Country
Canada
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Secondary sponsor category [1]
256383
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None
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Name [1]
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Address [1]
256383
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Country [1]
256383
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Alberta Health Research Ethics Board
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Ethics committee address [1]
258512
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308 Campus Tower 8625-112 Street Edmonton, AB T6G 1K8
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Ethics committee country [1]
258512
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Canada
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Date submitted for ethics approval [1]
258512
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23/06/2004
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Approval date [1]
258512
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01/07/2004
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Ethics approval number [1]
258512
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pro00001233
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Summary
Brief summary
To determine the impact of a bedside decision support tool on the quality of care delivered to Alberta hemodialysis (HD) patients. The tool will recommend patient-specific evidence-based management changes to the nephrologist most responsible for each patient. This health services research concerns two of four Health Research Priority Themes: information management for health improvement and continuum of care and delivery models. Findings will be relevant to health professionals and decision-makers responsible for care of HD patients.
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Trial website
N/A
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Trial related presentations / publications
None at present
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Public notes
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Contacts
Principal investigator
Name
30124
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Address
30124
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Country
30124
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr, Marcello Tonelli
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Address
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Associate Professor, Medicine/Nephrology, University of Alberta, Clinical Sciences Building (CSB) 11-107, 8440 112 St. Edmonton, Alberta T6G 2B7
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Country
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Canada
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Phone
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+1 780-407-8520
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dawn Opgenorth
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Address
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Clinical Research Manager
University of Alberta,
Research Transition Facility (RTF) 3050
8308 114 St
Edmonton, Alberta
T6G 2V2
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Country
4299
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Canada
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Phone
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+1 780 407-1543
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Fax
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+1 780 407-3270
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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