An interventional study of Electronic Clinical Decision Support Alert in Ankle Injuries, Ankle Sprains and Ankle Fractures, sponsored by SPECHBACH Hervé. Completed at 1 site in Switzerland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-03.
Sponsored by SPECHBACH Hervé · Not applicable, Interventional, and Health services research
Ankle injuries are a common reason for emergency department visits. Although fractures are relatively uncommon, ankle and foot X-rays are frequently ordered to exclude them. The Ottawa Ankle Rules are clinical decision rules designed to help healthcare professionals identify patients who require radiographic imaging. This study evaluated whether an electronic pop-up reminder of the Ottawa Ankle Rules could reduce the number of ankle and foot X-rays prescribed in the emergency department. The study also assessed adherence to the Ottawa Ankle Rules and evaluated their diagnostic performance for identifying fractures.
Ankle injuries are a frequent cause of emergency department consultations and often result in radiographic examinations. Despite the low prevalence of fractures, many patients undergo ankle or foot X-rays, leading to unnecessary radiation exposure, increased waiting times, and additional healthcare costs. The Ottawa Ankle Rules (OAR) were developed as a clinical decision aid to safely reduce unnecessary imaging while maintaining a high sensitivity for fracture detection.
This before-and-after study evaluated the impact of an electronic clinical decision support intervention consisting of a pop-up alert reminding physicians of the Ottawa Ankle Rules when ordering imaging for ankle injuries in the emergency department. During the pre-intervention period, physicians followed standard clinical practice. During the intervention period, the electronic reminder was available during the imaging ordering process.
The primary objective was to assess the proportion of patients presenting to the emergency department with ankle trauma who underwent radiographic examination before and after implementation of the electronic alert. Secondary objectives included assessing and comparing the proportion of prescribed X-rays that met Ottawa Ankle Rules criteria before and after implementation of the intervention. The diagnostic performance of the Ottawa Ankle Rules was also evaluated by calculating sensitivity, specificity, and negative predictive value for fracture identification.
202 studies on the registry are indexed under Ankle Fractures; 44 are open to participants now.
This study's enrollment of 312 is above the median of 90 across 150 interventional studies indexed under Ankle Fractures.
Browse Ankle Fractures studies →This is the only study on the registry with SPECHBACH Hervé as lead sponsor.
Compared within Ankle Fractures, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Ankle Injuries. The counts are of registry records indexed under each term, refreshed daily. How we classify →
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Exclusion Criteria:
Patients presenting with ankle trauma to the Emergency Department between 1 November 2021 and 31 January 2022. Physicians followed standard routine practice without an electronic clinical decision support alert based on the Ottawa Ankle Rules.
Patients presenting with ankle trauma to the Emergency Department between 1 February 2022 and 30 April 2022. Physicians were exposed to an electronic clinical decision support pop-up alert reminding them to apply the Ottawa Ankle Rules when assessing ankle injuries and ordering imaging.
Behavioral: Electronic Clinical Decision Support Alert
An electronic clinical decision support pop-up alert integrated into the emergency department workflow. The alert reminded physicians to apply the Ottawa Ankle Rules when evaluating patients with ankle trauma and when considering ankle or foot radiography. The intervention was implemented during the post-intervention period (1 February 2022 to 30 April 2022) and was intended to reduce unnecessary imaging while maintaining appropriate fracture detection
Proportion of Patients Receiving Ankle or Foot Radiography
Assessment of the proportion of patients presenting to the emergency department with ankle trauma who underwent ankle or foot radiography before and after implementation of the electronic clinical decision support alert based on the Ottawa Ankle Rules.
Time frame: During the emergency department visit (up to 1 day)
Proportion of Radiographs Meeting Ottawa Ankle Rules Criteria
Proportion of prescribed ankle and foot radiographs that met Ottawa Ankle Rules criteria before and after implementation of the electronic clinical decision support alert.
Time frame: During the emergency department visit (up to 1 day)
Sensitivity of the Ottawa Ankle Rules for Fracture Detection
Diagnostic sensitivity of the Ottawa Ankle Rules for identifying fractures among patients presenting with ankle trauma.
Time frame: Up to 2 weeks after the emergency department visit
Specificity and Negative Predictive Value of the Ottawa Ankle Rules
Diagnostic specificity and negative predictive value of the Ottawa Ankle Rules for excluding fractures among patients presenting with ankle trauma.
Time frame: Up to 2 weeks after the emergency department visit
Plan to share: Yes
No publications or documents are linked to this record.
Ran from Nov 2021 to primary completion in Apr 2022, 5 months.
Of 69 non-industry interventional studies with no phase under Ankle Fractures, half reached primary completion within 44 months of starting (the median), counting those still running; a quarter within 23 and three quarters within 61. This study's 5 months is below that.
Counting every sponsor, half of 72 studies reached it within 45 months; a quarter within 23 and three quarters within 61.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is completed, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.
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