Title
Enrollment into a time sensitive clinical study in the critical care setting: results from computerized septic shock sniffer implementation.
Abstract
Objective Recruitment of patients into time sensitive clinical trials in intensive care units (ICU) poses a significant challenge. Enrollment is limited by delayed recognition and late notification of research personnel. The objective of the present study was to evaluate the effectiveness of the implementation of electronic screening (septic shock sniffer) regarding enrollment into a time sensitive (24 h after onset) clinical study of echocardiography in severe sepsis and septic shock. Design We developed and tested a near-real time computerized alert system, the septic shock sniffer, based on established severe sepsis/septic shock diagnostic criteria. A sniffer scanned patients' data in the electronic medical records and notified the research coordinator on call through an institutional paging system of potentially eligible patients. Measurement The performance of the septic shock sniffer was assessed. Results The septic shock sniffer performed well with a positive predictive value of 34%. Electronic screening doubled enrollment, with 68 of 4460 ICU admissions enrolled during the 9 months after implementation versus 37 of 4149 ICU admissions before sniffer implementation (p<0.05). Efficiency was limited by study coordinator availability (not available at nights or weekends). Conclusions Automated electronic medical records screening improves the efficiency of enrollment and should be a routine tool for the recruitment of patients into time sensitive clinical trials in the ICU setting.
Year
DOI
Venue
2011
10.1136/amiajnl-2011-000228
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
Keywords
Field
DocType
machine learning,decision support,near real time,clinical trial,sniffer
Septic shock,Time sensitive,Clinical trial,Intensive care medicine,Medical record,Clinical study,Sepsis,Intensive care,Medicine,Study Coordinator
Journal
Volume
Issue
ISSN
18
5
1067-5027
Citations 
PageRank 
References 
2
0.42
3
Authors
4
Name
Order
Citations
PageRank
Vitaly Herasevich12917.49
Matthew S Pieper220.42
Juan Pulido320.76
Ognjen Gajic435.56