The study team previously designed a CDS tool (PE CALC), using Wells' Score for PE, to reduce unnecessary computed tomography pulmonary angiography (CTPA) testing for pulmonary embolus (PE) that is efficacious (37% reduction among tool adopters) when used.(1) To evaluate the feasibility, acceptability and preliminary efficacy on provider adoption of a new tool, that includes nudges to improve provider tool adoption, compared to the current tool, in a pilot trial. The primary feasibility outcome will be post-pilot provider satisfaction. Analysis for preliminary efficacy will include a comparison of provider adoption rates with the new tool and those of the old tool, using retrospective data.
The central hypothesis of this proposal is that the addition of a theory-informed nudge to a clinical decision support (CDS) tool will address identified behavioral barriers to use and significantly improve adoption by providers. Nudges are applications of behavioral science, defined as positive reinforcement and indirect suggestions that have a non-forced effect on decision making. This study will use a behavioral theory-informed process to develop a new CDS tool that includes a nudge that addresses barriers to adoption.