AF Risk EHR Alert for Ischemic Stroke
(PreMISe-AF Trial)

Recruiting in Palo Alto (17 mi)

Overseen bySteven A Lubitz, MD, MPH

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Massachusetts General Hospital

No Placebo Group

Trial Summary

What is the purpose of this trial?The overall goal of this study is to minimize morbidity due to Atrial Fibrillation (AF). The specific objective is to develop and implement a rational and personalized approach to AF risk estimation that can inform management decisions with ischemic stroke. The investigators propose to develop a clinical AF risk estimation tool in the electronic health record and to test the effectiveness of implementing a clinical AF risk estimation tool into care for use by stroke neurologists during the care of acute ischemic stroke patients at Massachusetts General Hospital. The investigators will evaluate cardiac monitoring utilization calibrated to AF risk by stroke neurologists using a custom electronic health record (EHR) notification module. The investigators hypothesize that cardiac rhythm monitoring utilization will be positively correlated with the predicted risk of AF.

Eligibility Criteria

This trial is for adults 18 or older who have had an ischemic stroke or transient ischemic attack and are admitted to the Massachusetts General Hospital inpatient stroke service. It's not open to those who don't meet these specific conditions.

Inclusion Criteria

I am 18 or older and was diagnosed with a stroke or mini-stroke at Massachusetts General Hospital.

Exclusion Criteria

Patients not meeting the above inclusion criteria

Participant Groups

The study aims to develop a tool that predicts atrial fibrillation (AF) risk, integrated into the electronic health record system. It will test if this tool helps doctors decide on heart monitoring for stroke patients based on their AF risk.

1Treatment groups

Experimental Treatment

Group I: Atrial Fibrillation Risk Estimation ToolExperimental Treatment1 Intervention

For eligible patients presenting with an acute ischemic stroke, a clinical atrial fibrillation risk estimation tool will be displayed in the patient's electronic health record through a best practice alert (BPA). The alert will display for the stroke neurologist caring for the patient when they first open the patient's chart. The neurologist may accept the automatically generated atrial fibrillation risk score displayed in the BPA, may modify some of the inputs of the score based on the patient's personal medical history and re-calculate, or may choose to dismiss the BPA.