New Randomized Controlled Study Published in JAMA Demonstrates the Value of Clinical Decision Support Tools in Preventing Acute Kidney Injury in Patients Undergoing Coronary Angiography
November 1, 2022
– Researchers used Terumo Health Outcomes’ ePRISM® software to calculate safe contrast volume targets and improve overall patient outcomes –
SOMERSET, NJ – November 1, 2022 – A new study published in JAMA1 demonstrated that patients at high risk for acute kidney injury (AKI), the most common complication of percutaneous coronary intervention (PCI), had a significant reduction in AKI when cardiologists used Terumo Health Outcomes’ (THO’s) ePRISM clinical decision support (CDS) platform.
“The three-year randomized study shows the benefits of the THO ePRISM platform to strategically target the high-risk portion of the population. For many cardiovascular service line programs, the rate of reduction in AKI shown in this study, using ePRISM technology, can improve their hospitals’ quality performance metrics from middle to top decile. This can result in lower costs to the hospital and better outcomes for patients,” said Michael J. Martinelli, MD, FACC, FSCAI and Chief Medical Officer, Terumo Medical Corporation.
“Contrast-associated AKI is the most common complication of coronary angiography and PCI, and contributes to higher costs for healthcare systems and negative outcomes for patients,” said John A. Spertus, MD, MPH, Professor of Medicine at the University of Missouri-Kansas City and co-author of the study. “By incorporating ePRISM to define ‘safe’ contrast limits for each individual patient, coupled with protocol-driven hydration, physicians were able to deliver much safer care. Using tools like ePRISM to improve outcomes represents the future of precision medicine in routine clinical practice.“
ePRISM uses the most valid risk model available to predict – on an individual basis – patients’ risks for AKI and establishes patient-specific contrast limits to help guide safer PCI. Armed with this knowledge, clinicians can make informed, pre-procedure treatment decisions and modify their approaches during treatment to minimize risk and improve outcomes.
“This study further underscores how Terumo Health Outcomes’ unique approach to partnering with healthcare systems to achieve optimal performance – by prospectively incorporating CDS tools like ePRISM into clinical workflows and providing feedback – can be a differentiated and impactful way to drive quality and efficiency into healthcare,” added Ryan Graver, Divisional Vice President, Terumo Health Outcomes.
The study participants included 31 invasive cardiologists from three cardiac catheterization laboratories in Alberta, Canada. Physicians performed 7820 procedures among 7106 patients who had a predicted AKI risk of greater than 5%. When ePRISM was used, the proportion of procedures exceeding the safe contrast limits was reduced from 51.7% to 38.1%.
During the intervention period, cardiologists received educational outreach, computerized CDS on contrast volume and hemodynamic-guided intravenous fluid targets, and audit and feedback. During the control period, cardiologists provided usual care and did not receive the intervention training or tools. The primary outcome was AKI. There were 12 secondary outcomes, including contrast volume, intravenous fluid administration, and major adverse cardiovascular and kidney events. The analyses were conducted using time-adjusted models.
1. Effect of Clinical Decision Support With Audit and Feedback on Prevention of Acute Kidney Injury in Patients Undergoing Coronary Angiography: A Randomized Clinical Trial. Published in The Journal of the American Medical Association (JAMA) Sept. 6, 2022; Volume 328, Number 9. Study led by Matthew T. James, MD, PhD, Assistant Professor with the University of Calgary.
About Terumo Health Outcomes
Combining best-in-class care pathway consulting services with proven, state-of-the-art ePRISM® precision medicine software platform, Terumo Health Outcomes (www.terumohealthoutcomes.com), a division of Terumo Medical Corporation, partners with clinicians and hospitals to deliver enhanced patient outcomes and operational efficiencies. The predictive power of ePRISM allows Terumo to deliver innovative digital solutions, providing clinicians with comprehensive, predictive patient analytics and critical data to enhance treatment at the point of care – ultimately lowering the cost of healthcare delivery.
About Terumo Medical Corporation
Terumo Medical Corporation (TMC) is a subsidiary of Terumo Corporation, founded in 1972 as the United States expansion of our larger Tokyo-based parent. For nearly 50 years, TMC has continued the Terumo mission of offering the best possible solutions to healthcare providers and the people they serve. TMC provides products and services across four divisions: Terumo Health Outcomes (THO), which provides healthcare systems with solutions designed to reduce care variation, improve quality metrics, minimize cost and maximize revenue; Terumo Interventional Systems (TIS), which offers solutions for entry site management and lesion access; Terumo Medical Products (TMP), which provides devices for injection and infusion therapy; and Terumo Pharmaceutical Solutions (TPS), which develops drug delivery devices.
Terumo (TSE:4543) is a global leader in medical technology and has been committed to "Contributing to Society through Healthcare" for 100 years. Based in Tokyo and operating globally, Terumo employs more than 28,000 associates worldwide to provide innovative medical solutions in more than 160 countries and regions. The company started as a Japanese thermometer manufacturer and has been supporting healthcare ever since. Now, its extensive business portfolio ranges from vascular intervention and cardio-surgical solutions, blood transfusion and cell therapy technology, to medical products essential for daily clinical practice such as transfusion systems, diabetes care, and peritoneal dialysis treatments. Terumo will further strive to be of value to patients, medical professionals, and society at large. More information can be found at www.terumo.com.