Prediction using a randomized evaluation of data collection integrated through connected technologies (PREDICT): Design and rationale of a randomized trial of patients discharged from the hospital to home.


Journal

Contemporary clinical trials
ISSN: 1559-2030
Titre abrégé: Contemp Clin Trials
Pays: United States
ID NLM: 101242342

Informations de publication

Date de publication:
08 2019
Historique:
received: 20 02 2019
revised: 19 06 2019
accepted: 27 06 2019
pubmed: 3 7 2019
medline: 3 10 2020
entrez: 3 7 2019
Statut: ppublish

Résumé

Hospital readmission prediction models often perform poorly. A critical limitation is that they use data collected up until the time of discharge but do not leverage information on patient behaviors at home after discharge. PREDICT is a two-arm, randomized trial comparing ways to use remotely-monitored patient activity levels after hospital discharge to improve hospital readmission prediction models. Patients are randomly assigned to use a wearable device or smartphone application to track physical activity data. The study collects also validated assessments on patient characteristics as well as disparate data on credit scores and medication adherence. Patients are followed for 6 months. We evaluate whether these data sources can improve prediction compared to standard modelling approaches. The PREDICT Trial tests a novel method of remotely-monitoring patient behaviors after hospital discharge. Findings from the trial could inform new ways to improve the identification of patients at high-risk for hospital readmission. Clinicaltrials.gov Identifier: NCT02983812.

Sections du résumé

BACKGROUND
Hospital readmission prediction models often perform poorly. A critical limitation is that they use data collected up until the time of discharge but do not leverage information on patient behaviors at home after discharge.
METHODS
PREDICT is a two-arm, randomized trial comparing ways to use remotely-monitored patient activity levels after hospital discharge to improve hospital readmission prediction models. Patients are randomly assigned to use a wearable device or smartphone application to track physical activity data. The study collects also validated assessments on patient characteristics as well as disparate data on credit scores and medication adherence. Patients are followed for 6 months. We evaluate whether these data sources can improve prediction compared to standard modelling approaches.
CONCLUSION
The PREDICT Trial tests a novel method of remotely-monitoring patient behaviors after hospital discharge. Findings from the trial could inform new ways to improve the identification of patients at high-risk for hospital readmission.
TRIAL REGISTRATION
Clinicaltrials.gov Identifier: NCT02983812.

Identifiants

pubmed: 31265915
pii: S1551-7144(19)30127-2
doi: 10.1016/j.cct.2019.06.018
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT02983812']

Types de publication

Clinical Trial Protocol Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

53-56

Informations de copyright

Published by Elsevier Inc.

Auteurs

Chalanda N Evans (CN)

The Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia, PA, United States of America.

Kevin G Volpp (KG)

Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America; The Wharton School, University of Pennsylvania, Philadelphia, PA, United States of America; The Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia, PA, United States of America; The LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, United States of America; Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States of America.

Daniel Polsky (D)

Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America; The Wharton School, University of Pennsylvania, Philadelphia, PA, United States of America; The LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, United States of America.

Dylan S Small (DS)

The Wharton School, University of Pennsylvania, Philadelphia, PA, United States of America; The Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia, PA, United States of America; The LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, United States of America.

Edward H Kennedy (EH)

Carnegie Mellon University, Pittsburgh, PA, United States of America.

Kelsey Karpink (K)

The Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia, PA, United States of America.

Rachel Djaraher (R)

The Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia, PA, United States of America.

Nicole Mansi (N)

The Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia, PA, United States of America.

Charles A L Rareshide (CAL)

The Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia, PA, United States of America.

Mitesh S Patel (MS)

Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America; The Wharton School, University of Pennsylvania, Philadelphia, PA, United States of America; The Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia, PA, United States of America; The LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, United States of America; Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States of America. Electronic address: mpatel@pennmedicine.upenn.edu.

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