Automatic Prompts for Aortic Stenosis

(Echo Prompts Trial)

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Ottawa Heart Institute Research Corporation

Disqualifiers: Cardiologist follow-up, Less than moderate AS/MR

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines whether adding specific prompts to echocardiogram reports can expedite referrals for patients with serious heart valve issues to heart specialists. It tests two types of prompts: one suggests seeing any cardiologist, while the other recommends a specific heart center. The goal is to determine if these prompts increase and speed up referrals compared to not using any prompts. This trial suits patients diagnosed with moderate or severe aortic stenosis or mitral regurgitation who are not already seeing a cardiologist. As an unphased trial, it allows patients to contribute to innovative strategies for improving heart care referrals.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these automatic prompts are safe for patients with aortic stenosis?

Research has shown that recommending a visit to a heart specialist for patients with severe aortic stenosis (a heart valve problem) can lead to better health outcomes. Patients generally receive these recommendations well, and no negative side effects have been reported. The goal is to help patients access necessary care more quickly. This approach has successfully improved health outcomes and reduced hospital visits for heart issues over time. Therefore, these recommendations are considered safe for guiding treatment decisions. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Automatic Prompts for Aortic Stenosis trial because it explores a new method of enhancing physician decision-making in the management of valvular heart disease. Unlike traditional options that rely heavily on the physician's initiative to refer patients for specialist care, this approach uses automated prompts to nudge physicians to consider referrals to cardiologists or specialized centers. The trial is unique because it investigates whether these prompts can improve patient outcomes by ensuring timely and appropriate referrals, potentially leading to better management of aortic stenosis. This innovative strategy aims to bridge the gap between diagnosis and specialized care, offering a potentially more efficient pathway for patient treatment.

What evidence suggests that this trial's prompts could be effective for increasing cardiologist referrals for aortic stenosis?

This trial will compare different automatic prompts for patients with aortic stenosis. Research has shown that automatic reminders can improve patient health. In this trial, participants in Intervention arm 1 will receive a prompt suggesting referral to a Cardiologist, while those in Intervention arm 2 will receive a prompt suggesting referral to the UOHI Center for Valvular Heart Disease. Studies indicate that such reminders can lower healthcare costs and lead to better treatment results. Specifically, structured communication like reminders helps patients with severe aortic stenosis receive care more quickly. Timely treatment is crucial, as it can reduce the risk of hospitalization for heart failure. Overall, automatic reminders ensure patients receive the right care faster, improving their health outcomes. ^{1 6 7 8 9}

Who Is on the Research Team?

David Messika-Zeitoun, MD

Principal Investigator

Ottawa Heart Institute Research Corporation

Are You a Good Fit for This Trial?

This trial is for patients with heart valve conditions like Aortic Valve Stenosis or Mitral Regurgitation. Participants must have been diagnosed through echocardiography but haven't yet seen a cardiologist for these specific issues.

Inclusion Criteria

I haven't seen a cardiologist in the last 2 years.

Consent provided

I have been diagnosed with severe heart valve issues.

Exclusion Criteria

Less than moderate AS and MR

Patients followed by a cardiologist or referred for a TTE by a Cardiologist

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive echocardiographic reports with or without automatic prompts suggesting referral to a cardiologist

6 months

Follow-up

Participants are monitored for referral rates and time to cardiologist evaluation after receiving echocardiographic reports

6 months

What Are the Treatments Tested in This Trial?

Interventions

• No Prompt
• Prompt 1
• Prompt 2

Trial Overview The study tests if adding automatic suggestions to echocardiogram reports affects how quickly and often patients see a heart specialist. There are three groups: no suggestion, one type of prompt, and another that includes help from a specialized center.

How Is the Trial Designed?

Group I: Intervention arm 1 Active Control 1 Intervention

In this case, the prompt included will say "Your patient has been diagnosed with a moderate / severe valvular heart disease. Consider referral to a Cardiologist."

Group II: Intervention arm 2 Active Control 1 Intervention

In this case, the prompt included will say "Your patient has been diagnosed with a moderate /severe valvular heart disease. Consider referral to the UOHI Center for Valvular Heart Disease".

Group III: Control arm Placebo Group 1 Intervention

In this case no prompt will be added.

Who Is Running the Clinical Trial?

Ottawa Heart Institute Research Corporation

Lead Sponsor

Trials

200

Recruited

95,800+

Citations

1. ir.edwards.com ir.edwards.com/news/news-details/2025/Prompt-Intervention-for-Severe-Aortic-Stenosis-Patients-Demonstrates-Lower-Healthcare-Costs-Improved-Clinical-Outcomes/default.aspx

Prompt Intervention for Severe Aortic Stenosis Patients ... Prompt Intervention for Severe Aortic Stenosis Patients Demonstrates Lower Healthcare Costs, Improved Clinical Outcomes · Significantly lower ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11722150/

Management, Flow, and Outcomes of Patients with Aortic ... Management, flow, and outcomes of patients with aortic stenosis followed by a heart valve clinic: The untold “behind the scene” from a high-volume, real-world ...

3. ahajournals.org ahajournals.org/doi/10.1161/JAHA.125.041889?doi=10.1161/JAHA.125.041889

Contemporary Resource Use and Costs Among Patients ... Over the study period, 6892 patients presented with severe AS, of whom 3334 (48%) were managed medically and 2812 (41%) were similar (based on ...

4. withpower.com withpower.com/trial/automatic-prompts-for-aortic-stenosis-a2ec9

Automatic Prompts for Aortic Stenosis · Info for Participants The study on facilitated data relay shows that structured communication can improve the timeliness of treatment for severe aortic stenosis, suggesting that ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S2666521225000043

Development and validation of a moderate aortic stenosis ... We aimed to develop and validate a machine learning model (ML) for predicting rapid progression from moderate to severe AS within one year.

6. jacc.org jacc.org/doi/10.1016/j.jacadv.2025.102039

Urgent vs Elective Transcatheter Aortic Valve Replacement ... In this low-intermediate risk cohort, urgent TAVR offered comparable procedural success and adjusted 30-day mortality to elective TAVR but was ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11168151/

Pilot study to evaluate the use of remote patient monitoring ... In people who develop symptoms, without valve replacement, prognosis is dismal with mortality as high as 50% at 1 year. In asymptomatic patients ...

8. treatheartvalvefailure.com treatheartvalvefailure.com/hcp/about-tavr-by-edwards/patient-outcomes

Patient Outcomes | Heart Valve Failure HCP Prompt TAVR resulted in a 68% lower risk of hospitalization for heart failure through 5 years vs clinical surveillance (5.3% vs 12%).

9. resourcelibrary.edwardsconnect.com resourcelibrary.edwardsconnect.com/api/v3/view/d3eecf

For Patients With Severe Aortic Stenosis (AS), Your Prompt ... 2014;98(5):1564-1571. Prompt referral to a Heart Valve Team upon diagnosis is the first crucial step to lifesaving outcomes for your severe AS patients.1.