[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100054311":3},{"organization":4,"armGroups":7,"interventions":19,"overallOfficials":25,"centralContacts":29,"locations":18,"responsibleParty":34,"collaborators":36,"id":42,"slug":43,"hasResults":44,"nctId":45,"briefTitle":46,"officialTitle":47,"acronym":18,"eligibilityCriteria":48,"healthyVolunteers":44,"sex":49,"minAge":50,"maxAge":18,"enrollmentInfo":51,"targetDuration":18,"studyType":54,"phases":55,"briefSummary":57,"conditions":58,"keywords":61,"overallStatus":68,"whyStopped":18,"lastUpdateSubmitDate":69,"lastUpdatePostDateStruct":70,"startDateStruct":73,"completionDateStruct":75,"leadSponsor":77,"locationsCount":18},{"fullName":5,"class":6},"Johns Hopkins University","OTHER",[8,14],{"label":9,"type":10,"description":11,"interventionNames":12},"Perioperative Cardiovascular Clinical Decision Support","EXPERIMENTAL","Participants receive standard perioperative care in a health system where an educational clinical decision support tool is available within the Epic electronic health record. The CDS tool provides evidence-informed, multidisciplinary recommendations regarding perioperative cardiovascular testing, specialty consultation, and institutional workflows for urgent inpatient surgery. The tool is advisory only, does not automate orders or replace clinician judgment, and clinicians may override or disregard its recommendations at any time.",[13],"Behavioral: Educational Clinical Decision Support Tool",{"label":15,"type":16,"description":17,"interventionNames":18},"Arm 1: Usual Care","NO_INTERVENTION","Participants receive standard perioperative evaluation and management according to existing institutional practice prior to implementation of the clinical decision support tool. Clinical decisions regarding cardiovascular testing and specialty consultation are made at the discretion of the treating clinicians without access to the study CDS tool.",null,[20],{"type":21,"name":22,"description":23,"armGroupLabels":24,"otherNames":18},"BEHAVIORAL","Educational Clinical Decision Support Tool","An educational clinical decision support (CDS) tool integrated within the Epic electronic health record via the AgileMD platform that provides evidence-informed recommendations for perioperative cardiovascular evaluation of adults undergoing urgent inpatient surgery. The tool includes guidance on appropriate cardiovascular testing, specialty consultation, and institutional workflows, based on American Heart Association perioperative recommendations adapted for the inpatient setting through multidisciplinary consensus among hospital medicine, cardiology, anesthesiology, and perioperative medicine stakeholders. The CDS tool is advisory only, does not automate orders or replace clinician judgment, and clinicians may follow, modify, or disregard its recommendations based on individualized patient assessment.",[9],[26],{"name":27,"affiliation":5,"role":28},"Phillip Wagner, MD","PRINCIPAL_INVESTIGATOR",[30],{"name":27,"role":31,"phone":32,"phoneExt":18,"email":33},"CONTACT","14128418522","pwagner6@jh.edu",{"type":35,"investigatorFullName":18,"investigatorTitle":18,"investigatorAffiliation":18,"oldNameTitle":18,"oldOrganization":18},"SPONSOR",[37,40],{"name":38,"class":39},"Agency For Healthcare Research & Quality","UNKNOWN",{"name":41,"class":6},"Patient-Centered Outcomes Research Institute","100054311","how-institutional-guidelines-for-urgent-inpatient-surgeries-affect-intensity-of-perioperative-cardiovascular-testing-100054311",false,"NCT07692503","How Institutional Guidelines for Urgent Inpatient Surgeries Affect Intensity of Perioperative Cardiovascular Testing","PERLHS: How Institutional Guidelines for Urgent Inpatient Surgeries Affect Intensity of Perioperative Cardiovascular Testing: A PrePost Study","Inclusion Criteria:\n\n* Adults age 18 years or older\n* Admitted through the Emergency Department at Johns Hopkins Hospital or Johns Hopkins Bayview Medical Center Undergoing urgent inpatient surgery during the index hospitalization\n\nExclusion Criteria:\n\n* Elective surgeries,\n* Outpatient procedures,\n* Procedures followed only by observation or extended-stay recovery rather than inpatient admission,\n* Patients younger than 18 years old","ALL","18 Years",{"count":52,"type":53},3000,"ESTIMATED","INTERVENTIONAL",[56],"NA","This study will evaluate the impact of implementing an educational clinical decision support (CDS) tool designed to guide perioperative cardiovascular evaluation for adults undergoing urgent inpatient surgery. The CDS tool, integrated within the Epic electronic health record via AgileMD, provides evidence-informed recommendations regarding perioperative cardiac testing and specialty consultation based on American Heart Association guidance and multidisciplinary institutional consensus. The investigators will conduct a retrospective and prospective pre-post observational cohort study comparing perioperative cardiovascular testing intensity, consultation patterns, time to operating room, and clinical outcomes before and after implementation of the tool among adult patients admitted through the emergency department at Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center who undergo urgent surgery. Data will be obtained from the Core for Clinical Research Data Acquisition (CCDA) and Epic electronic health record, with case-level chart review performed as needed to validate rare outcomes such as major adverse cardiac events.",[59,60],"Major Adverse Cardiovascular Events","Cardiovascular Testing and Consultation Intensity",[62,63,64,65,66,67],"Perioperative Care","Preoperative Care","Clinical Decision Support Systems","Hospital Medicine","High Value Care","Testing intensity","NOT_YET_RECRUITING","2026-07-09",{"date":71,"type":72},"2026-07-13","ACTUAL",{"date":74,"type":53},"2026-12",{"date":76,"type":53},"2028-06",{"name":5,"class":6}]