An interventional study of Levels of Diagnostic and Therapeutic Intervention tool by Fontecha and col. and Usual clinical practice in Acute Disease, sponsored by Consorci Sanitari de l'Alt Penedès i Garraf. Not yet recruiting at 1 site in Spain. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-12-05.
Sponsored by Consorci Sanitari de l'Alt Penedès i Garraf · Not applicable, Interventional, and Supportive care
The objective of this clinical trial is to investigate the impact of implementing a tool for adjusting the level of diagnostic and therapeutic intensity in the clinical practice of physicians attending hospitalized patients.
The goal of this clinical trial is to investigate the impact of a tool for adjusting diagnostic and therapeutic intensity in hospitalized patients. The main question it aims to answer is: Is there a difference in patient mortality when using the aforementioned tool? The participating physicians will be grouped into 4 groups (5 physicians each). Each group will progressively (every 3 months) incorporate the use of the aforementioned tool into their usual clinical practice.
Exclusion Criteria:
Medical doctors assigned to this group will incorporate a Levels of Diagnostic and Therapeutic Intervention tool into their clinical practice
Other: Levels of Diagnostic and Therapeutic Intervention tool by Fontecha and col.
Medical doctors assigned to this group will continue their clinical practice as usual
Other: Usual clinical practice
During the intervention periods, participating physicians will integrate into their usual clinical practice a tool for adjusting diagnostic and therapeutic intensity designed by Fontecha-Gómez and colleagues. The tool for adjusting the level of diagnostic and therapeutic intensity classifies patients' profiles into 5 groups based on the recommended level of adjustment.
The participating physicians will carry out the standard clinical practice currently performed in the study centers. This means that during this period, the diagnostic and therapeutic adjustment tool or any similar tool will not be introduced into routine clinical practice.
In-hospital Patient Mortality at 90 days from hospital discharge
Percentage of patients who die during hospitalization until 90 days from hospital discharge.
Time frame: 90 days from hospital discharge
In-hospital Patient Mortality at 6 months from hospital discharge
Percentage of patients who die during hospitalization until 6 months from hospital discharge.
Time frame: 6 months from hospital discharge
In-hospital Patient Mortality at 1 year from hospital discharge
Percentage of patients who die during hospitalization until 1 year from hospital discharge.
Time frame: 1 year from hospital discharge
Delirium Incidence
Percentage of patients with delirium occurrence during hospital admission (delirium already present at the time of admission will not be considered). Delirium will be evaluated through Confusion Assessment Method (CAM)
Time frame: hospital discharge, assessed up to day 90
Pressure Ulcer Incidence
Percentage of patients with pressure ulcer occurrence during hospital admission (pressure ulcers already present at the time of admission will not be considered).
Time frame: hospital discharge, assessed up to day 90
Hospital stay
Hospital stay in days
Time frame: hospital discharge, assessed up to day 90
Hospital readmission for any reason
Percentage of patients readmitted for any reason within 30 days of hospital discharge.
Time frame: 30 days from hospital discharge
Hospital readmission for same reason
Percentage of patients readmitted for the same reason within 30 days of hospital discharge.
Time frame: 30 days from hospital discharge
Patients admitted to the Intensive Care Unit (ICU)
Percentage of patients admitted to the ICU during hospitalization
Time frame: hospital discharge, assessed up to day 90
Calls to the "on-call doctor"
Number of calls to the "on-call doctor" during hospital admission
Time frame: hospital discharge, assessed up to day 90
Healthcare expenditure
Descriptive analysis of healthcare expenditure associated with each intervention, using the billing data from the center.
Time frame: through study completion, an average of 1.5 years
Mortality at ICU
Percentage of patients admitted to the ICU
Time frame: hospital discharge, assessed up to day 90
Plan to share: Yes — IPD (without personal identification data) could be shared by requirement from other researchers after the end of the study, and only for research proposels and previous approval of promotor center of the study (CSAPG). Anyway, Spanish and European Union legal policy about data protection will strictly be followed (IPD will not be transferred outside European Union).
Supporting information: Study protocol
This study is not yet recruiting, as verified in Dec 2025. You cannot join it, but the record below documents what was studied.
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Consorci Sanitari de l'Alt Penedès i Garraf