Animated Picture to Improve Provider Adherence to CT Scan for Head Injury Rule

Minor Head Injury Clinical Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01514071
• Other study ID #: 1103-040
• Status: Completed
• Phase: N/A
• First received: January 12, 2012
• Last updated: July 30, 2013
• Start date: February 2012
• Est. completion date: July 2013

Study information

• Verified date: July 2013
• Source: Children's Hospitals and Clinics of Minnesota
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

It is difficult for Pediatric Emergency Department providers to recognize clinically significant head injuries that are likely to require neurosurgical intervention or close monitoring from those that can be safely discharged.

Research Question How do a combination of education and an animated picture depicting the PECARN CT Head Injury rules impact compliance to these rules and reduce unnecessary head CT scans?

Design This is a within subject, repeated measures study design.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 746
• Est. completion date: July 2013
• Est. primary completion date: July 2013
• Accepts healthy volunteers: No
• Gender: Both
• Age group: N/A to 18 Years

Eligibility

Inclusion Criteria:

• Patients presenting to Children's ED will be included if they:

• Are between 0 and 18 years of age (inclusive)

• Receive a discharge diagnosis of head injury

• Present to the ED within 24 hours of the head injury

• GCS of 14 or greater

Exclusion Criteria:

• Patients will be excluded if they :

• Had a CT scans done in an outside transferring institution

• Have obvious penetrating head injuries

• Had a trivial injury mechanisms such as ground-level falls or walking or running into stationary objects

• Have no signs or symptoms of head trauma other than scalp abrasions and lacerations.

• Have known brain tumors, pre-existing neurological disorders complicating assessment, ventricular shunts, bleeding disorders

Study Design

Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic

Related Conditions & MeSH terms

• Craniocerebral Trauma
• Minor Head Injury

Intervention

Behavioral:
• Pop-up picture
An animated picture depicting the key elements of the PECARN CT scan head injury rules will be explained. The picture will "pop-up" when a provider selects the order set for a CT scan due to head injury. Providers will need to select a box stating the patient either "meets criteria" or "does not meet criteria" in order to close the animated picture window.

Locations

Country	Name	City	State
United States	Children's Hospitals and Clinics of Minnesota	Minneapolis	Minnesota
United States	Children's Hospitals and Clinics of Minnesota	Twin Cities	Minnesota

Sponsors (1)

Lead Sponsor	Collaborator
Children's Hospitals and Clinics of Minnesota

Country where clinical trial is conducted

United States, 

References & Publications (1)

Kuppermann N, Holmes JF, Dayan PS, Hoyle JD Jr, Atabaki SM, Holubkov R, Nadel FM, Monroe D, Stanley RM, Borgialli DA, Badawy MK, Schunk JE, Quayle KS, Mahajan P, Lichenstein R, Lillis KA, Tunik MG, Jacobs ES, Callahan JM, Gorelick MH, Glass TF, Lee LK, Bachman MC, Cooper A, Powell EC, Gerardi MJ, Melville KA, Muizelaar JP, Wisner DH, Zuspan SJ, Dean JM, Wootton-Gorges SL; Pediatric Emergency Care Applied Research Network (PECARN). Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009 Oct 3;374(9696):1160-70. doi: 10.1016/S0140-6736(09)61558-0. Epub 2009 Sep 14. Erratum in: Lancet. 2014 Jan 25;383(9914):308. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Compliance to the PECARN CT Scan Head Injury rules		3 months	Yes
Secondary	Decreased rate of CT scans		3 months	Yes