End Diagnostic Overshadowing

Conditions

• Disabilities Multiple

Eligibility Criteria

Sex

ALL

Age

3 Years - 89 Years

Healthy Volunteers

Accepted

Interventions

• Electonic health record prompts with education — BEHAVIORAL
  1. . A baseline description of patients aged ≥ 3 to 89 years old with one or more of 26 diagnoses prone to error was developed to compare cases of patients with specific disabilities (major mobility impairments, severe mental health concerns, severe visual impairments, severe hearing loss, and IDD) versus cases of patients without the specific disabilities who have these diagnoses. 2. Initial manual chart reviews on PWDs with specific diagnoses of sepsis and metastatic breast cancer with two of the disability groups, patients with intellectual disabilities and/or autism and with severe mental illness were done. 3. We analyzed mammogram usage and factors related to usage among women ≥ 40 years old with IDD and with severe mental health issues 3\) We are working on algorithms to identify providers whose female patients age \> 40 years old to encourage outreach and to identify the patients needing mammograms for outreach. Developing educational materials for both providers and patients.
• Standard of care — OTHER
  Patients without disabilities will receive standard care related to electronic health record prompts, alerts, and decision supports.

Study Details

The goal of this study is to address the critical issue of diagnostic overshadowing by applying the Collective Impact Model40 to co-produce our End Diagnostic Overshadowing program with academic, health systems, health professional, PWDs, family members, and community stakeholders. Through this work, we will identify and address mechanisms that contribute to diagnostic overshadowing and diagnostic errors among people with disabilities. The main questions to answer are whether knowledge about diagnostic errors and confidence will improve with health care providers and professionals involved in diagnostic provesses, whether developed algorithms to identify patients at risk of diagnpstic error will be used, whether there will be change in time to diagnostic evaluation for PWD from the specified 5 population groups and with the specified diagnoses prone to error, and whether changes in usage of CPT Evaluation and Management codes will occur.

Key Dates

First listed

Sep 23, 2024

Start date

Nov 22, 2024

Status verified

Jul 2026

Primary completion

Mar 31, 2029

Completion

Jul 31, 2029

Study Design

Enrollment

120,000 participants (estimated)

Arms

• Arm: Patients with disabilities
  Cases with disabilities are patients aged 3 - 89 years old with one or more of 26 diagnoses prone to error and and have the following secondary (or primary) diagnoses (using associated ICD-10 codes) Mobility impairments: Spinal cord diseases, Spinal cord injuries, Injury to spinal cord nerves, Multiple sclerosis, Cerebral palsy, Dependence on enabling machines or devices, Need for caregiver related to mobility impairments Severe Vision impairments: Severe Hearing impairments: Mental health: Person history mental and behavioral disorders, Major Depression, Severe bipolar disorder, Severe schizophrenia, Paranoia, Psychosis Intellectual Disabilities: Autism
• Arm: Patients without disabilities
  Patients without disabilities are patients age 3-89 with one or more of 26 diagnoses prone to error and without the following secondary (or primary) diagnoses: Mobility impairments: Spinal cord diseases, Spinal cord injuries, Injury to spinal cord nerves, Multiple sclerosis, Cerebral palsy, Dependence on enabling machines or devices, Need for caregiver related to mobility impairments Severe Vision impairments: Severe Hearing impairments: Mental health: Person history mental and behavioral disorders, Major Depression, Severe bipolar disorder, Severe schizophrenia, Paranoia, Psychosis Intellectual Disabilities: Autism

Primary Outcome Measure

Descriptive data on use of electronic record (EHR) decision supports and prompts/alerts [ Time Frame: 1.5, 2.5, and 3.5 years ]

Central Contacts

• Director Research Affairs
  312-942-3554
  [email protected]
• Tricia J Johnson, PhD
  312-942-7107
  [email protected]

Locations (1)

Find similar trials in Chicago, IL

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