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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2300070555 |
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最近更新日期: Date of Last Refreshed on: |
2023-04-17 09:26:11 |
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注册时间: Date of Registration: |
2023-04-17 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
社区肾脏病临床辅助决策系统多中心整群随机对照临床试验 |
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Public title: |
A Cluster Randomized Trial Comparing the Effects of the CDSS vs. Usual Care practice in Patients with Chronic Kidney Disease at Primary Care Setting |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
社区肾脏病临床辅助决策系统多中心整群随机对照临床试验 |
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Scientific title: |
A Cluster Randomized Trial Comparing the Effects of the CDSS vs. Usual Care practice in Patients with Chronic Kidney Disease at Primary Care Setting |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
惠淼 |
研究负责人: |
吕继成 |
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Applicant: |
Miao Hui |
Study leader: |
Jicheng Lv |
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申请注册联系人电话: Applicant telephone: |
+86 15652177188 |
研究负责人电话: Study leader's telephone: |
+86 13161753111 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
drpennyhui@163.com |
研究负责人电子邮件: Study leader's E-mail: |
chenglv@263.net |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
北京市西城区西什库大街8号 |
研究负责人通讯地址: |
北京市西城区西什库大街8号 |
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Applicant address: |
No. 8, Xishiku Street, Xicheng District, Beijing |
Study leader's address: |
No. 8, Xishiku Street, Xicheng District, Beijing |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
北京大学第一医院 |
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Applicant's institution: |
Peking University First Hospital |
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研究负责人所在单位: |
北京大学第一医院 |
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Affiliation of the Leader: |
Peking University First Hospital |
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是否获伦理委员会批准: |
是/Yes |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
2022研489-002489 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
北京大学第一医院生物医学研究伦理委员会 |
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Name of the ethic committee: |
Biomedical Research Ethics Committee, Peking University First Hospital |
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伦理委员会批准日期: Date of approved by ethic committee: |
2022-12-19 00:00:00 |
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伦理委员会联系人: |
于岩岩 |
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Contact Name of the ethic committee: |
Yanyan YU |
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伦理委员会联系地址: |
北京市西城区西什库大街8号 |
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Contact Address of the ethic committee: |
No. 8, Xishiku Street, Xicheng District, Beijing |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 10 66119025 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
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研究实施负责(组长)单位: |
北京大学第一医院 |
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Primary sponsor: |
Peking University First Hospital |
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研究实施负责(组长)单位地址: |
北京市西城区西什库大街8号 |
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Primary sponsor's address: |
No. 8, Xishiku Street, Xicheng District, Beijing |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
中央高水平医院临床科研专项 |
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Source(s) of funding: |
Central High level Hospital Clinical Research Funding |
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Target disease: |
Chronic kidney disease |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
其它 | ||||||||||||||||||||||
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Study phase: |
N/A |
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研究设计: |
整群随机分组 |
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Study design: |
Cluster randomization |
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研究目的: |
开展一项基于社区肾脏病CDSS的临床有效性的多中心整群随机对照研究,探索与临床常规诊疗相比,在社区医疗中联合CDSS系统对肾脏疾病诊疗实践中的有效性,包括辅助提高社区全科医师的肾脏疾病诊疗能力,改善患者临床结局,降低肾脏疾病群体医疗负担 |
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Objectives of Study: |
A multi-center cluster-randomized controlled study based on the clinical efficacy of CDSS in community nephropathy was carried out to explore the effectiveness of CDSS system in community care in the diagnosis and treatment of kidney disease compared with clinical routine diagnosis and treatment, including helping to improve the diagnosis and treatment ability of community general practitioners, improve clinical outcomes of patients, and reduce the medical burden of kidney disease groups |
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药物成份或治疗方案详述: |
慢性肾脏病临床辅助决策系统(CDSS),嵌入电子病历系统,完成以下辅助诊断和治疗推荐,具体包括 1.基于电子病历系统自动抓取肾脏病高危人群,推荐肾脏病早期筛查 2.基于肌酐估算的肾小球滤过率或尿液蛋白尿检测进行慢性肾脏病辅助诊断以及相关的鉴别诊断 3.根据风险模型进行风险评级以及达到转诊条件推荐转诊 4.对于CKD患者推荐血压降压目标及RAAS阻断剂应用,对于糖尿病肾病同时推荐SGLT2抑制剂 5.根据肾功能推荐有关贫血、钙磷代谢等并发症等监测推荐 |
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Description for medicine or protocol of treatment in detail: |
The Chronic Kidney Disease Clinical Assisted Decision System (CDSS), embedded in the electronic medical record system, completes the following auxiliary diagnosis and treatment recommendations, including 1. Based on the electronic medical record system, it automatically captures high-risk groups of renal disease, and recommends early screening of kidney disease. 2. Auxiliary diagnosis of chronic kidney disease and related differential diagnosis based on creatinine estimation of glomerular filtration rate or urine proteinuria detection. 3. Conduct risk rating according to the risk model and recommend referral if the referral conditions are met. 4. Blood pressure lowering goals and RAAS blockers are recommended for patients with CKD, and SGLT2 inhibitors are recommended for diabetic nephropathy 5. According to renal function recommendations, monitoring recommendations for anemia, calcium and phosphorus metabolism and other complications. |
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纳入标准: |
1.年龄>18岁 2.社区就诊符合CKD诊断标准,包括基于血肌酐的CKD-EPI估算肾小球滤过率<60ml/min per 1.73m2 或伴有蛋白尿,定义为尿常规尿蛋白≥1+或尿ACR>30mg/g 3.CKD高危人群,包括以下人群糖尿病、高血压、心血管疾病、既往AKI病史、肾脏病家族史、肾结石、肥胖、高龄(>60岁); 4. 每年社区医疗就诊次数2次以上. |
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Inclusion criteria |
1. Age> 18 years old |
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排除标准: |
1.妊娠; |
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Exclusion criteria: |
1. Pregnancy |
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研究实施时间: Study execute time: |
从 From 2023-04-01 00:00:00至 To 2026-04-01 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2023-04-17 00:00:00 至 To 2026-04-01 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
独立于本研究的统计师使用计算机随机化系统将30家中心随机分为对照组和干预组。随机化结果各中心在开始干预分配前是保密的。各参与中心同意参与该项研究,并同意在开始干预分配前不知晓开始干预分配的具体时间。 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
Statisticians independent of this study used a computer randomization system to randomly divide 30 centers into control and intervention groups. Randomization results were kept confidential by centres until intervention allocation was initiated. The participating centres agreed to participate in the study and agreed not to |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
公开/Public |
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盲法: |
研究不对社区医生和患者设盲。 |
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Blinding: |
The study did not blind community physicians and patients. |
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试验完成后的统计结果(上传文件): |
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Calculated Results after
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是否共享原始数据: IPD sharing |
No |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
N/A |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
N/A |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
本研究前瞻性数据采集是通过西城区卫健委数据平台联通CDSS应用服务器,按照社区当前诊疗开发临床数据交换标准协会病例报告表CDISC-CRF,从临床EHR和LIS等源数据中自动提取诊疗过程数据生成eCRF,数据脱敏后(隐私数据保护),通过卫建专线定期同步(T+1)天至“联合实验室”生成科研数据集。科研数据库使用的是关系型数据库PostgreSQL,面向临床诊疗数据,设计了不同的数据域,涵盖了患者就诊、诊断、处方、门诊病历、生命体征、检验报告,其中诊断数据、药品处方数据、检验报告数据经过了标准归一化处理,使数据更易用于科研研究。 本研究的观察终点为慢性肾脏病患者住院率的变化,该部分数据是通过链接北京市住院医保数据库获取。北京医保患者经三级医院住院后均会产生全面准确的住院记录,包括人口统计学、治疗、临床诊断(ICD-10),医疗花费和所在科室信息记录,保障了研究观察终点可追溯。 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
The prospective data collection of this study was connected to the CDSS application server through the data platform of the Xicheng District Health Commission, and the case report form of the Association of Clinical Data Exchange Standards for the Development of Clinical Data Exchange in the community was automatically extracted from the source data such as clinical EHR and LIS to generate eCRF, and after data desensitization (privacy data protection), scientific research data was generated through regular synchronization (T+1) days to the "joint laboratory" through the Weijian special line. The scientific research database uses the relational database PostgreSQL, which designs different data domains for clinical diagnosis and treatment data, covering patient visits, diagnosis, prescriptions, outpatient medical records, vital signs, and test reports, among which diagnostic data, drug prescription data, and test report data have been standardized and processed to make the data easier to use for scientific research. The endpoint of this study was the change in hospitalization rate of patients with chronic kidney disease, and this part of the data was obtained by linking to the Beijing inpatient medical insurance database. After being hospitalized in a tertiary hospital, Beijing medical insurance patients will produce comprehensive and accurate hospitalization records, including demographics, treatment, clinical diagnosis (ICD-10), medical expenses and department information records, ensuring the traceability of the study observation endpoints. |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
有/Yes |