The study evaluates, in 3 emergency departments (ED) and on randomized alternate periods, the use of SmartUrgences®, Augmented Intelligence (AI) software to help the interpretation of bone standard X-rays prescibed by the ED.
"The study evaluates, in 3 emergency departments (ED) and on randomized alternate periods, the use of SmartUrgences®, Augmented Intelligence (AI) software to help the interpretation of bone radiographs prescibed by the ED. The primary objective of the organizational study is to evaluate, compared to the current organization for the interpretation of standard bone radiographs requested by the ED, the impact of an organization incorporating the Milvue solution, on the reduction of the patient diagnostic error rate. A cost-consequence study is carried out, comparing from the point of view of the community (production costs according to the HAS recommendations), the radiological diagnosis within the framework of an organization with the Milvue solution, to that within the framework of the current organization without the use of the Milvue solution. The economic study will follow the scheme of the organizational study, comparing the periods with and without the Milvue solution and analyzing the costs and consequences, by period and by patient. This is an open-label randomized cluster multiple period cross-over study with 6 alternate periods (3 with AI, 3 with usual organization) of 1 month in each ED. The choice of the intervention for the first period will be randomized."
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
8,400
X-rays are done in the radiology department and the images are made available to emergency physicians with the AI interpretation. X-rays flagged by IA as anormal or suspicious will be reviewed without delay by the radiologist, non-flagged X-rays will be reviewed by radiologists on a delayed basis.
Hopital Saint Antoine
Paris, France
RECRUITINGHôpital Salpétrière
Paris, France
RECRUITINGHôpital Tenon
Paris, France
RECRUITINGDiagnostic error rate
A diagnostic error is defined as a final consensus diagnosis that differs from the diagnosis documented in the medical record by the emergency physician prior to patient's discharge from the ED. A diagnostic error is defined as a final consensus diagnosis that differs from the diagnosis documented in the medical record by the emergency physician prior to patient's discharge from the ED.
Time frame: Through patient's discharge from the emergency department, an average of 1 day
Time between x-ray and first diagnostic
Time between x-ray and first diagnostic, either by the emergency physician or by the radiologist
Time frame: Through patient's discharge from the emergency department, an average of 1 day
Time between x-ray and first diagnostic by the emergency physician
Time between x-ray and first diagnostic by the emergency physician in the patient medical file
Time frame: Through patient's discharge from the emergency department, an average of 1 day
Time between x-ray and final diagnostic by the emergency physician
Time between x-ray and final diagnostic by the emergency physician in the patient medical file. A diagnostic will be considered as final if the same as the consensus one
Time frame: 30 days
Rate of X-rays interpretation by radiologist without delay
Rate of X-rays interpretation by radiologist without delay (i.e within 1 hour)
Time frame: 1 hour
Number of all radiological exam per patient prescribed by the ED
Number of all radiological exam per patient prescribed by the ED (MRI, scanner, x-rays, echography)
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Time frame: Through patient's discharge from the emergency department, an average of 1 day
Number of X-rays with a report by a radiologist at 30 days
Number of X-rays with a report by a radiologist at 30 days
Time frame: 30 days
Time spent in the ED by the patient
Time spent in the ED by the patient
Time frame: Through patient's discharge from the emergency department, an average of 1 day
Number of patients invited to come back in the ED
Number of patients invited to come back in the ED
Time frame: 30 days
30 days morbidity
New ED visit, hospitalization, radiological exam or outpatient visit, for the same reason as the first ED visit
Time frame: 30 days
Total cost from the hospital viewpoint
Total cost from the hospital viewpoint
Time frame: 30 days