Evaluating the impact of a machine-learning clinical decision support tool on provider practice when evaluating febrile patients with Kawasaki Disease (KD) and non-KD illnesses.
Following laboratory evaluation, providers will be randomized to treat patients according to usual practice/standard of care vs. receiving clinical decision support from the Kawasaki MATCH tool - a previously validated machine-learning clinical decision support tool to identify Kawasaki Disease. The study aim is to evaluate the accuracy of Kawasaki MATCH prospectively when used at the point of care, as well as how this tool impacts clinical decisions including additional evaluation and hospital admission.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
200
Providers access the Kawasaki MATCH decision support tool. Patient information is entered into the tool and a risk score is indicated to the provider. Kawasaki MATCH is a previously validated machine-learning decision support tool for the diagnosis of Kawasaki Disease. This tool utilizes patient age, 18 laboratory features, and 5 clinical features to formulate a risk score.
Rady Children's Hospital, San Diego
San Diego, California, United States
RECRUITINGTime to Kawasaki Disease treatment (KD patients only)
Time in days from initial ED evaluation to initial IVIG treatment in patients ultimately diagnosed with Kawasaki Disease
Time frame: 90 days
Kawasaki MATCH score
MATCH score determined by entering patient clinical and laboratory information into the Kawasaki MATCH algorithm. Algorithm output is a decimal between 0 and 1. Scores less than 0.4 will be deemed a prediction of "not Kawasaki Disease" while scores of 0.4 or higher will be deemed "Kawasaki Disease"
Time frame: Day 1 (day of enrollment)
Hospital Admission Rate
Proportion of patients admitted to the hospital from the Emergency Department (ED). Admitted patients = 1 Discharged patients = 0
Time frame: Day 1 (day of enrollment)
Kawasaki Disease consultation rate
Proportion of patients receiving Kawasaki service consultation
Time frame: Day 1 (day of enrollment)
ED return visit
Return to Emergency Department
Time frame: 7 days
Additional interventions
Additional ED orders for laboratory/imaging studies or additional procedures after the time of randomization
Time frame: Day 1 (day of enrollment)
Provider assessment of KD likelihood - baseline
Visual analog scale of suspected likelihood of Kawasaki Disease. Scale between 0 (Definitely not Kawasaki Disease) and 100 (Definitely Kawasaki Disease) with higher values indicating higher provider suspicion for Kawasaki Disease. This outcome will be assessed on providers randomized to both study arms
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Day 1 (day of enrollment)
Provider assessment of KD likelihood - after algorithm
Visual analog scale of suspected likelihood of Kawasaki Disease. Scale between 0 (Definitely not Kawasaki Disease) and 100 (Definitely Kawasaki Disease) with higher values indicating higher provider suspicion for Kawasaki Disease. This outcome only assessed for providers in the experimental arm.
Time frame: Day 1 (day of enrollment)
Algorithm helpfulness
Visual analog scale of the perceived helpfulness of the Kawasaki MATCH algorithm. Scale between 0 (Not helpful) and 100 (Extremely helpful) with higher values indicating increased helpfulness. This outcome only assessed for providers in the experimental arm.
Time frame: Day 1 (day of enrollment)