| Title: |
Performance of an Electronic Decision Support System as a Therapeutic Intervention During a Multicenter PICU Clinical Trial: Heart and Lung Failure-Pediatric Insulin Titration Trial (HALF-PINT) |
| Authors: |
Hirshberg, EL; Alexander, JL; Asaro, LA; Coughlin-Wells, K; Steil, GM; Spear, D; Stone, C; Nadkarni, VM; Agus, MSD; Wypij, D; Nadkarni, V; Srinivasan, V; Biagas, K; Mourani, PM; Chima, R; Thomas, NJ; Li, S; Pinto, A; Newth, C; Hassinger, A; Bysani, K; Rehder, KJ; Faustino, EV; Kandil, S; Hirshberg, E; Wintergerst, K; Schwarz, A; Bagdure, D; Marsillio, L; Cvijanovich, N; Pham, N; Quasney, M; Flori, H; Federman, M; Nett, S; Pinto, N; Viteri, S; Schneider, J; Medar, S; Sapru, A; McQuillen, P; Babbitt, C; Lin, JC; Jouvet, P; Yanay, O; Allen, C; Luckett, P; Fackler, J; Rozen, T |
| Publisher Information: |
Elsevier BV |
| Publication Year: |
2021 |
| Collection: |
The University of Melbourne: Digital Repository |
| Description: |
BACKGROUND: The use of electronic clinical decision support (CDS) systems for pediatric critical care trials is rare. We sought to describe in detail the use of a CDS tool (Children's Hospital Euglycemia for Kids Spreadsheet [CHECKS]), for the management of hyperglycemia during the 32 multicenter Heart And Lung Failure-Pediatric Insulin Titration trial. RESEARCH QUESTION: In critically ill pediatric patients who were treated with CHECKS, how was user compliance associated with outcomes; and what patient and clinician factors might account for the observed differences in CHECKS compliance? STUDY DESIGN AND METHODS: During an observational retrospective study of compliance with a CDS tool used during a prospective randomized controlled trial, we compared patients with high and low CHECKS compliance. We investigated the association between compliance and blood glucose metrics. We describe CHECKS and use a computer interface analysis framework (the user, function, representation, and task analysis framework) to categorize user interactions. We discuss implications for future randomized controlled trials. RESULTS: Over a 4.5-year period, 658 of 698 children were treated with the CHECKS protocol for ≥24 hours with a median of 119 recommendations per patient. Compliance per patient was high (median, 99.5%), with only 30 patients having low compliance ( |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
0012-3692 |
| Relation: |
https://hdl.handle.net/11343/296262 |
| Availability: |
https://hdl.handle.net/11343/296262 |
| Rights: |
https://creativecommons.org/licenses/by-nc-nd/4.0 ; CC BY-NC-ND |
| Accession Number: |
edsbas.FDCB2820 |
| Database: |
BASE |