Development of a Simple, Point-of-Care Device to Test Anorectal Function in Patients with Constipation: Randomized Clinical Trial

Background Urinary tract infection (UTI) is a common disease in childhood. A sterile collection of urine samples using suprapubic aspiration (SPA) and bladder catheterization (BC) is helpful for rapid and accurate diagnosis of UTI in infants. With the advent of point-of-care ultrasound (POCUS), the use of ultrasound by non-radiologists at the patient’s bedside, great advancement has been noticed in various medical fields. Considering the importance and advantages of using POCUS in the physical examination and guiding procedures, the authors aimed to compare urine sampling’s success rate by SPA, BC, and POCUS guided SPA (POCUS-SPA) in infants performed by three pediatricians. Materials and methods This study is a randomized clinical trial conducted on 114 neonates and infants with suspected UTI admitted to 17-Shahrivar children’s hospital from April 2017 to September 2019. Neonates and infants were randomly assigned to three groups of BC, SPA, and POCUS-SPA. The primary outcome was the success of sampling defined by obtaining 1cc of urine in each method. The secondary outcome was assessing the pain level. Results Results showed that the POCUS-SPA had the highest success rate in urine sampling, and a statistically significant relation was noted among the three groups (P = 0.0001). From 38 patients in each group, 37 patients of POCUS-SPA (97.4%), 34 patients of BC (89.5%), and 23 patients of SPA (60.5%) had a successful sampling. Most of the patients in all three groups experienced severe pain. Conclusions In the current study, results showed that the POCUS-SPA significantly increased the success rate of urine sampling and most of the patients in all three groups had severe pain. Based on the shortage of access to radiologists in emergency setups, it seems that the POCUS-SPA by the pediatricians can be one of the most appropriate and applicable diagnostic methods in infants with UTI.

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A randomized clinical trial comparing point-of-care platelet function assays and bleeding time in healthy subjects treated with aspirin or clopidogrel

Platelets ◽

10.3109/09537104.2011.604806 ◽

2011 ◽

Vol 23 (4) ◽

pp. 249-258 ◽

Cited By ~ 6

Author(s):

Fabian Chen ◽

Victor Maridakis ◽

Edward A. O’neill ◽

Chan Beals ◽

Waldemar Radziszewski ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Platelet Function ◽

Healthy Subjects ◽

Bleeding Time ◽

Point Of Care ◽

Platelet Function Assays

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Faculty Opinions recommendation of Point-of-care testing: a prospective, randomized clinical trial of efficacy in coagulopathic cardiac surgery patients.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717954456.793461135 ◽

2012 ◽

Author(s):

Glenn Murphy

Keyword(s):

Clinical Trial ◽

Cardiac Surgery ◽

Randomized Clinical Trial ◽

Point Of Care ◽

Point Of Care Testing ◽

Prospective Randomized Clinical Trial

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Randomized clinical trial of point-of-care, limited ultrasonography for trauma in the emergency department: Sonography outcomes assessment program (SOAP)-1 trial

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2004.07.009 ◽

2004 ◽

Vol 44 (4) ◽

pp. S2 ◽

Cited By ~ 2

Author(s):

L.A. Melniker ◽

M.G. McKenney ◽

E. Liebner ◽

W.M. Briggs

Keyword(s):

Clinical Trial ◽

Emergency Department ◽

Randomized Clinical Trial ◽

Outcomes Assessment ◽

Point Of Care ◽

Assessment Program

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Effectiveness of electronic point-of-care reminders versus monthly feedback to improve adherence to 10 clinical recommendations in primary care: a cluster randomized clinical trial

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-019-0976-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Ermengol Coma ◽

Manuel Medina ◽

Leonardo Méndez ◽

Eduardo Hermosilla ◽

Manuel Iglesias ◽

...

Keyword(s):

Primary Care ◽

Clinical Trial ◽

Randomized Clinical Trial ◽

Point Of Care ◽

Intervention Group ◽

Control Group ◽

Electronic Reminder ◽

Clinical Recommendations ◽

Cluster Randomized ◽

Clinical Conditions

Abstract Background Numerous studies have analyzed the effectiveness of electronic reminder interventions to improve different clinical conditions, and most have reported a small to moderate effect. Few studies, however, have analyzed reminder systems targeting multiple conditions, and fewer still have compared electronic point-of-care reminders systems with other forms of feedback designed to improve delivery of care. Methods We performed an unblinded cluster randomized clinical trial to compare the effectiveness of an electronic point-of-care reminder system with that of a well-established system providing monthly feedback on adherence to clinical recommendations. The control group received monthly feedback only while the intervention group received monthly feedback in addition to on-screen point-of-care reminders for 10 clinical conditions. The study targeted all physicians and nurses at the 283 primary care centers managed by the Institut Català de la Salut (approximately 6600 professionals). Results Following exclusions and randomization, 132 primary care centers (328,728 patients with reminders) were assigned to the intervention group while 137 centers (317,117 patients with reminders) were randomized to the control group. A 20.6% improvement (OR 1.29, 95% CI: 1.25–1.34) in reminder resolution rates was observed in the intervention group. Results varied according to the clinical condition. The most effective reminder was screening for diabetic retinopathy (OR 1.51, 95% CI:1.46–1.57) while the least effective reminders were measurement of glycated hemoglobin (OR: 1.10, 95% CI: 1.07–1.13) and smoking cessation encouragement (OR 1.12, 95% CI: 1.09–1.16). Conclusions Electronic point-of-care reminders were more effective than the existing monthly feedback system at resolving the 10 clinical situations. However, more studies are needed to investigate the variations of the effect observed. Trial registration Current Controlled Trials ISRCTN42391639, 08/10/2012. Retrospectively registered.

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