[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100658174":3},{"organization":4,"outcomesModule":7,"designInfo":14,"detailedDescription":21,"studyPopulation":13,"armGroups":22,"interventions":29,"overallOfficials":13,"centralContacts":34,"locations":13,"responsibleParty":44,"collaborators":48,"id":52,"slug":53,"hasResults":54,"nctId":55,"briefTitle":56,"officialTitle":56,"acronym":57,"eligibilityCriteria":58,"healthyVolunteers":54,"sex":59,"minAge":60,"maxAge":13,"enrollmentInfo":61,"targetDuration":13,"studyType":64,"phases":65,"briefSummary":66,"conditions":67,"keywords":70,"overallStatus":76,"whyStopped":13,"lastUpdateSubmitDate":77,"lastUpdatePostDateStruct":78,"startDateStruct":81,"completionDateStruct":82,"leadSponsor":84,"locationsCount":13},{"fullName":5,"class":6},"Foundation for Advancing Science Technology Education and Research","OTHER",{"primaryOutcomes":8,"secondaryOutcomes":13,"otherOutcomes":13},[9],{"measure":10,"description":11,"timeFrame":12},"Receipt of ILD Screening","Proportion of eligible patients who receive an ILD screening test (high-resolution CT \\[HRCT\\] or pulmonary function test \\[PFT\\]) within 7 days of a clinic visit.","Within 7 days of the index rheumatology clinic visit",null,{"allocation":15,"interventionModel":16,"interventionModelDescription":17,"primaryPurpose":18,"observationalModel":13,"timePerspective":13,"maskingInfo":19},"NA","SEQUENTIAL","The intervention model is randomized stepped-wedge cluster model. All sites receive the intervention, but at staggered, randomized time points.","PREVENTION",{"masking":20,"maskingDescription":13,"whoMasked":13},"NONE","Interstitial lung disease (ILD) is a common and serious complication of rheumatoid arthritis (RA) and systemic sclerosis (SSc). Despite guideline recommendations, ILD screening in routine care remains low, and many patients are not evaluated until their lung disease is advanced. This study evaluates a pragmatic, clinic-integrated strategy designed to increase timely ILD screening using tools embedded directly into the electronic health record (EHR).\n\nThe project is conducted within community rheumatology practices that share a common EHR platform (NextGen). All participating sites transition from usual care to the intervention, but at different scheduled time points. This stepped-wedge design allows each site to contribute both control-phase and intervention-phase data. Screening is not researcher-initiated; instead, the intervention is designed to support and standardize existing clinical workflows.\n\nThe intervention consists of two components implemented at the clinic level. First, patients complete a brief respiratory symptom survey on a tablet at check-in. The questionnaire captures dyspnea and cough severity and is designed to take under two minutes. The results become available to clinicians in real time. Second, EHR-embedded clinical decision support (CDS) prompts appear for clinicians when patients meet predefined criteria based on diagnosis, test history, and symptom scores. These prompts remind clinicians of guideline-recommended ILD screening and facilitate ordering of pulmonary function tests or high-resolution computed tomography when appropriate. Sites also receive training and a structured workflow guide to support implementation.\n\nBecause the intervention is deployed within routine clinical care, patients are passively included when they present for appointments and meet study criteria in the EHR. No additional study visits, procedures, or medications are required. Data are collected from the EHR, CDS activity logs, and patient-reported surveys. The study observes ordering and completion of ILD screening tests, provider responses to alerts, symptom patterns, and documentation of new ILD diagnoses. Data are analyzed to compare screening activity before and after the clinic transitions to the intervention, adjusting for time effects and patient and site characteristics.\n\nThe study aims to generate practical evidence on whether embedding guideline-aligned CDS and rapid symptom assessments into existing workflows can improve ILD screening for RA and SSc patients in real-world community practice. Findings may help inform broader implementation strategies for early detection of ILD and other pulmonary complications in rheumatology populations.",[23],{"label":24,"type":25,"description":26,"interventionNames":27},"EHR-Embedded CDS and PRO Tools","EXPERIMENTAL","This is a quality-improvement, workflow-embedded intervention, the stepped-wedge design evaluates the effect of an active intervention (EHR-embedded CDS + PRO tools).",[28],"Other: EHR-Embedded CDS and PRO Tools Intervention",[30],{"type":6,"name":31,"description":32,"armGroupLabels":33,"otherNames":13},"EHR-Embedded CDS and PRO Tools Intervention","This intervention integrates two components directly into routine rheumatology clinic workflows using the shared NextGen electronic health record (EHR). First, patients complete a brief tablet-based respiratory symptom questionnaire at check-in, capturing dyspnea and cough severity in under two minutes. Responses are transmitted instantly into the EHR. Second, the system activates ILD-focused clinical decision support (CDS) prompts for clinicians based on diagnosis, prior testing history, and symptom scores. These prompts recommend guideline-aligned ILD screening and provide structured options for ordering pulmonary function tests or high-resolution chest CT. The CDS also records provider responses and reasons for deferring screening. The intervention is deployed at the site level and is intended to standardize ILD screening behavior, enhance recognition of respiratory symptoms, and support timely clinical action in RA and SSc patients.",[24],[35,40],{"name":36,"role":37,"phone":38,"phoneExt":13,"email":39},"Jeffrey R Curtis, MD, MS, MPH","CONTACT","205-937-0585","jc@fastermedicine.org",{"name":41,"role":37,"phone":42,"phoneExt":13,"email":43},"Stephanie S Ford, MS","205-410-8480","sf@fastermedicine.org",{"type":45,"investigatorFullName":46,"investigatorTitle":47,"investigatorAffiliation":5,"oldNameTitle":13,"oldOrganization":13},"PRINCIPAL_INVESTIGATOR","Jeffrey Curtis","Professor of Medicine",[49],{"name":50,"class":51},"Boehringer Ingelheim","INDUSTRY","100658174","improving-ild-screening-in-patients-with-ra-and-ssc-using-ehr-embedded-cds-and-pro-tools-100658174",false,"NCT07849673","Improving ILD Screening in Patients With RA and SSc Using EHR-Embedded CDS and PRO Tools","ILD-QUI","Participants must meet all of the following to be included:\n\nAge ≥ 18 years Diagnosis of rheumatoid arthritis (RA) or systemic sclerosis (SSc) No prior diagnosis of interstitial lung disease (ILD) No high-resolution CT (HRCT) or pulmonary function test (PFT) within the past 24 months\n\nParticipants meeting any of the following are excluded:\n\nConfirmed diagnosis of ILD Recent HRCT or PFT within the last 24 months without new symptoms","ALL","18 Years",{"count":62,"type":63},800,"ESTIMATED","INTERVENTIONAL",[15],"This is a quality improvement initiative that aims to find better ways to identify interstitial lung disease (ILD) early in people with rheumatoid arthritis (RA) or systemic sclerosis (SSc). ILD is a serious lung problem that can develop in these conditions but is often missed. The project will test whether tools built into the electronic health record (EHR), including symptom surveys that patients complete on a tablet and alerts that help doctors decide when lung testing is needed, can increase screening rates.\n\nAbout 16 rheumatology clinics that use the same EHR system will take part. All clinics will eventually use the new tools, but they will start at different times. This allows researchers to compare usual care to the new approach within each clinic.\n\nAdults with RA or SSc who have not previously been diagnosed with ILD and who have not had recent lung testing will be included automatically through their routine clinic visits. The study expects to include about 800 patients in total.\n\nThe main question is whether more eligible patients receive recommended ILD screening, which includes either a pulmonary function test or a high-resolution CT scan, within seven days of their clinic visit. The study will also look at how often lung tests are ordered and completed, how often patients report symptoms such as shortness of breath or cough, and whether the alerts lead to real-time clinical decisions.\n\nThis project lasts two years and uses information already collected during routine clinical care. No additional procedures or medications are required.",[68,69],"Rheumatoid Arthritis (RA)","SSc-Systemic Sclerosis",[71,72,73,74,75],"Rheumatology","ILD","Screening for ILD","RA patients","SSc patients","NOT_YET_RECRUITING","2026-09-24",{"date":79,"type":80},"2026-09-30","ACTUAL",{"date":79,"type":63},{"date":83,"type":63},"2027-06",{"name":5,"class":6}]