Clinical Decision Support Tool for Pulmonary Embolism

Not yet recruiting at 2 trial locations

Overseen By Natalie Henning

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: NYU Langone Health

Disqualifiers: Not at study sites

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new tool to help doctors in emergency departments decide when to order a CT scan for detecting blood clots in the lungs, known as pulmonary embolism (PE). The tool, called the Clinical Decision Support (CDS) tool with Nudges, uses "nudges" to encourage doctors to follow guidelines, aiming to reduce unnecessary scans. Ideal participants include emergency department doctors, nurse practitioners, or physician assistants who order CT scans for adult patients at specific hospital sites.

As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could enhance decision-making in emergency care.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this clinical decision support tool with nudges is safe for use in emergency departments?

Research has shown that the Clinical Decision Support (CDS) tool with nudges is both practical and effective. This tool aids doctors in making better decisions about ordering CT scans for pulmonary embolism (PE), a blood clot in the lungs. Studies have found that it helps doctors adhere more closely to guidelines.

The tool's safety pertains to its influence on decision-making rather than physical side effects. It has been used in emergency departments to assist doctors in treatment decisions. No reports indicate harmful effects from the tool itself. Instead, it aims to improve test ordering, reducing unnecessary scans and the potential harmful radiation from unneeded CT scans.

Overall, the CDS tool with nudges is well-accepted and has been positively received by doctors in previous studies. The focus remains on providing safe and effective support for decision-making. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Clinical Decision Support (CDS) tool with nudges for pulmonary embolism because it offers a fresh approach to improving diagnosis and treatment decisions in emergency departments. Unlike traditional methods that rely heavily on a clinician's individual judgment and standard diagnostic protocols, this tool integrates real-time data and intelligent prompts to guide providers more effectively. By serving as a decision-making aid, it aims to reduce human error and enhance the speed and accuracy of diagnosing pulmonary embolisms, potentially improving patient outcomes significantly.

What evidence suggests that this clinical decision support tool with nudges is effective for pulmonary embolism?

Research shows that using a Clinical Decision Support (CDS) tool with gentle prompts helps doctors make better choices when ordering CT scans for blood clots in the lungs (pulmonary embolism). This trial will implement the CDS tool with nudges in emergency departments to assess its effectiveness. Early studies have found that these tools guide doctors to follow medical guidelines more closely, reducing unnecessary CT scans. One study showed that a CDS tool, designed with insights from behavioral science, improved decision-making. By adding simple prompts, these tools become more effective, and doctors find them more satisfying to use. Overall, these findings suggest that CDS tools with prompts can improve how doctors order CT scans, potentially leading to better patient care. ^{1 2 3 5 6}

Who Is on the Research Team?

Safiya Richardson, MD MPH

Principal Investigator

NYU Langone Health

Are You a Good Fit for This Trial?

This trial is for emergency departments (EDs) within three health systems. It's designed to test if a new tool helps doctors follow guidelines when deciding if a CT scan is needed for patients suspected of having a pulmonary embolism.

Inclusion Criteria

A provider (MD, NP, PA) ordering CTs for evaluation of PE in adult patients present at study site Emergency Department (i.e., Northwell Health - Feinstein Institute for Medical Research, Baylor College of Medicine and NYU Langone Health)

I am 18 years old or older.

Exclusion Criteria

A provider not present at the specified study sites.

Timeline for a Trial Participant

Pre-implementation Baseline Data Collection

Collection of baseline data from each site's electronic health record (EHR) for 12 months

12 months

Implementation

Implementation of the CDS tool with nudges to examine adoption of guideline-concordant CT ordering for pulmonary embolism

33 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Clinical Decision Support (CDS) tool with Nudges

Trial Overview The study examines the effectiveness of combining a Clinical Decision Support (CDS) tool with nudges—small prompts or changes designed to encourage specific behavior—to see if they improve guideline-based use of CT scans in EDs.

How Is the Trial Designed?

Group I: Emergency Department (ED) Providers Experimental Treatment 1 Intervention

Each ED will serve as its own control. Baseline data will be collected for 12 months prior to the implementation of the CDS system with nudges. The CDS tool with nudges will then be implemented for 33 months.

Who Is Running the Clinical Trial?

NYU Langone Health

Lead Sponsor

Trials

1,431

Recruited

838,000+

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator

Trials

3,987

Recruited

47,860,000+

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT07249385

Nudging Provider Adoption of Clinical Decision Support ... The purpose of this study is to examine the impact of the nudge implementation strategy (CDS tool + Nudge) on adoption of guideline-concordant ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11293639/

Effect of a behavioral nudge on adoption of an electronic ... We demonstrated feasibility and preliminary efficacy of a PE risk prediction CDS tool developed using insights from behavioral science.

3. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2839599

AI-Driven Clinical Decision Support to Reduce Hospital ... This trial protocol describes a randomized clinical trial to assess artificial intelligence (AI)–driven clinical decision support in ...

4. jmir.org jmir.org/2025/1/e73189

Application of Nudges to Design Clinical Decision Support ... Principles from behavioral economics such as “nudges” may improve the effectiveness and clinician satisfaction of CDS tools. This paper outlines ...

5. clinicaltrials.gov clinicaltrials.gov/study/NCT05203185

Nudging Provider Adoption of Clinical Decision Support Full time employed Emergency Department providers used a CDS tool, Pulmonary Embolism Calculator (PE CALC), without nudges to improve use, to reduce ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12463335/

Application of Nudges to Design Clinical Decision Support Tools We have found many examples of nudges being used for CDS, including efforts to increase statin prescribing during primary care visits using ...