Evidence mapPaperPMID 40097147Full record

Trial reportApplied clinical informatics2025

User Actions within a Clinical Decision Support Alert for the Management of Hypertension in Chronic Kidney Disease.

Lipika Samal, Sarah W Chen, Stuart Lipsitz, Heather J Baer, John L Kilgallon, Michael Gannon, Ryan Dunk, Weng Ian Chay, Richard Fay, Michael Sainlaire and 9 more

Registry-linked trialAbstract readPragmatic Clinical TrialRandomized Controlled Trial
In one paragraph

Trial report in Applied clinical informatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03679247 (Electronic Tools to Increase Recognition and Improve Primary Care Management for Hypertension in Chronic Kidney Disease), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03679247 nacompletednot on this map

Electronic Tools to Increase Recognition and Improve Primary Care Management for Hypertension in Chronic Kidney Disease

TypeinterventionalSponsorBrigham and Women's HospitalRan2021 to 2022Enrolled2,026ConditionsChronic Kidney Diseases, HypertensionArmsIntervention, Control
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Lipika SamalDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Sarah W ChenDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Stuart LipsitzDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Heather J BaerDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
John L KilgallonDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Michael GannonDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Ryan DunkDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Weng Ian ChayDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Richard FayDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Michael SainlaireDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Chenxi GaoDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Matthew WienDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Pamela M GarabedianDepartment of Clinical and Quality Analysis, Mass General Brigham, Somerville, Massachusetts, United States.
Edward WuDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Hojjat SalmasianChildren's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.
David W BatesDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Patricia C DykesDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Adam WrightDepartment of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, United States.
Allison B McCoyDepartment of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, United States.

Funding

Electronic Tools to Increase Recognition and Improve Primary Care Management for Hypertension in Chronic Kidney Disease: A Multi-site Randomized Clinical TrialR01DK116898 · BRIGHAM AND WOMEN'S HOSPITAL · 2025 to 2025
$884k
NIDDK NIH HHS 5R01DK116898NIDDK NIH HHS R01 DK116898
6 · The paper itself

Abstract

This study aimed to examine user actions within a clinical decision support (CDS) alert addressing hypertension (HTN) in chronic kidney disease (CKD).A pragmatic randomized controlled trial of a CDS alert for primary care patients with CKD and uncontrolled blood pressure included prechecked default orders for medication initiation or titration, basic metabolic panel (BMP), and nephrology electronic consult (e-consult). We examined each type of action and calculated percentages of placed and signed orders for subgroups of firings.There were firings for medication initiation (813) and medication titration (430), and every firing also included orders for nephrology e-consult (1,243) and BMP (1,243). High rates of override (59.6%) and deferral (14.6%) were observed, and CDS-recommended orders were only signed about one-third of the time from within the alert. The percentage of orders that were signed after being placed within the alert was higher for medication initiation than for medication titration (33 vs. 12.0% for angiotensin-converting enzyme inhibitors [ACEi] and 38.8 vs. 14% for angiotensin II receptor blockers [ARBs]). Findings suggest that users are hesitant to commit to immediate action within the alert.Evaluating user interaction within alerts reveals nuances in physician preferences and workflow that should inform CDS alert design. This study is registered with the Clinicaltrials.gov Trial Registration (identifier: NCT03679247).

Indexed as

Decision Support Systems, ClinicalHypertensionRenal Insufficiency, ChronicFemaleHumansMaleMiddle Aged

Identifiers

PMID40097147
PMCPMC12221691

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.