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| Name | Class |
|---|---|
| Ohio State University | OTHER |
| Duke University | OTHER |
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Annually, an estimated 700,000 patients do not complete their scheduled MRI scans because of claustrophobia or inability to hold still. Training staffs working in MRI facilities to provide Comfort Talk® will enable patients to complete high quality imaging without medication, which will increase satisfaction and comfort while reducing sedation risks for patients, and increase efficiency and reduce loss of revenue for facilities. The effect of such training will be tested at 12 MRI sites in a randomized design. Outcome data will be collected for one year.
Claustrophobia and disruptive patient motion are common impediments to MRI examination, but they may be prevented or ameliorated with a non-pharmacologic behavioral intervention administered by trained staff. The potential benefits of such an intervention are highly significant, considering that the alternatives are to cancel the study or administer sedation. Inability to complete their MRI scans adversely affects an estimated 700,000 patients every year in the US. These patients are either deprived of a diagnosis, subject to diagnostic delays and interpretation errors due to motion artifact, or are exposed to risks of pharmacologic sedation, including death. The imaging facilities typically cannot fill the suddenly vacated examination slots in time before the next scheduled patient and incur considerable lost revenue and efficiency. A negative patient experience further jeopardizes Value-Based reimbursement by the Centers for Medicare and Medicaid Services (CMS) towards which patient satisfaction counts 30%. The long term goal is to provide a validated, clinically feasible means for non-pharmacologic amelioration of claustrophobia and disruptive patient motion, achieved by training facility staff in Comfort Talk®.
Comfort Talk® training consists of a proprietary, standardized R3 Process of Rapport, Relaxation, and Reframing including 2 x 8-hrs class-room interaction, onsite coaching, and institution-specific web-based support to help the MRI team to further develop its own language style and skill set.
The effect of Comfort Talk® training will be quantified in a prospective randomized design at 12 MRI satellites of the Ohio State University Medical Center and Duke University Medical Center. Return of investment of training will be based on a decision-analysis model with focus on number of scans performed, cancellations from no-shows and refusals; patients unable to start or complete a scan; and sedation rates in relation to capacity, cost, and reimbursement schedule. Patient satisfaction scores will be compared using Press Ganey national benchmark percentile rankings and CMS quality standards.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Comfort Talk® Training | Experimental | In the experimental group, MRI personnel is trained to use Comfort Talk® to help patients who are claustrophobic, anxious, and/or cannot lie still to complete their tests at the onset of the MRI scan. |
|
| Control | No Intervention | MRI sites not trained in Comfort Talk®. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Comfort Talk® Training | Behavioral | Personnel of MRI units is trained in advanced rapport skills, patient-centered and hypnoidal language, correct use of suggestions and skills of tension diffusion. This entails 16 hrs classroom work, additional on-site post-training support, and access to a post-training support web module resulting in at least 20 hrs training. |
| Measure | Description | Time Frame |
|---|---|---|
| Equipment Utilization Q4FY15 = Baseline Quarter (OSU) | Quarterly completion rate of MRIs as a proportion of scans completed per given number of imaging slots available | 1 quarter |
| Equipment Utilization in Q1FY16 (OSU) | Quarterly completion rate of MRIs as a proportion of scans completed per given number of imaging slots available | 1 quarter |
| Equipment Utilization in Q2FY16 (OSU) | Quarterly completion rate of MRIs as a proportion of scans completed per given number of imaging slots available | 1 quarter |
| Equipment Utilization in Q3FY16 (OSU) | Quarterly completion rate of MRIs as a proportion of scans completed per given number of imaging slots available | 1 quarter |
| Equipment Utilization Over All Quarters (OSU) | Completion rates of MRIs as a proportion of scans completed per given number of imaging slots available | 4 quarters |
| Incompletions (Duke) | Patients who cannot complete their scan | 9 months (3 months baseline, 6 months post training) |
| Measure | Description | Time Frame |
|---|---|---|
| No-shows in Q4FY15 = Baseline Quarter (OSU) | Quarterly number of scheduled patients who do not show up for their appointments | 1 quarter |
| No-shows in Q1FY16 (OSU) | Quarterly number of scheduled patients who do not show up for their appointments |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Elvira V Lang, MD | Hypnalgesics, LLC | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hypnalgesics, LLC | Brookline | Massachusetts | 02446 | United States | ||
| Duke University Medical Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19734060 | Background | Lang EV, Ward C, Laser E. Effect of team training on patients' ability to complete MRI examinations. Acad Radiol. 2010 Jan;17(1):18-23. doi: 10.1016/j.acra.2009.07.002. Epub 2009 Sep 5. | |
| 24261356 | Background | Lang EV, Yuh WT, Ajam A, Kelly R, Macadam L, Potts R, Mayr NA. Understanding patient satisfaction ratings for radiology services. AJR Am J Roentgenol. 2013 Dec;201(6):1190-5; quiz 1196. doi: 10.2214/AJR.13.11281. |
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Different participants were assessed at baseline and at each period after training.
Clinical sites, not participants, were enrolled in the study. Note that "participants" refers to all patients scheduled to be examined on the available imaging slots, including patients who showed ("completed") and those who were no-shows ("not completed").
At OSUMC randomization was maintained (3 trained, 3 control sites). At Duke University considerable staff cuts at the onset of the trial resulted in extensive staff rotations making maintenance of randomization impossible. Thus a pre-post training comparison for the 6 sites was done (pre-training baseline = control, post-training = training arm)
| ID | Title | Description |
|---|---|---|
| FG000 | Comfort Talk® Training | MRI clinical sites form the experimental group. Their personnel is trained to use Comfort Talk® to help patients who are claustrophobic, anxious, and/or cannot lie still to complete their tests at the onset of the study. Comfort Talk® Training: Personnel of MRI units is trained in advanced rapport skills, patient-centered and hypnoidal language, correct use of suggestions and skills of tension diffusion. This will entail 16 hrs classroom work, additional on-site post-training support, and access to a post-training support web module resulting in at least 20 hrs training. |
| FG001 | Control | MRI sites are not be trained in Comfort Talk®. Please note that at OSU both trained and control sites had a baseline and three post-training periods. At Duke, the data in the initial baseline period became the control data in a pre to post comparison for reasons explained above. Therefore Duke has only 2 time periods with the initial "Baseline" entered as "Control." |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OSU Baseline Q4FY15 |
| |||||||||||||
| OSU Q1FY16 (First Post-Training Quarter) |
| |||||||||||||
| OSU Q2FY16(Second Post Training Quarter) |
| |||||||||||||
| OSU Q3FY16 (Third Post Training Quarter) |
| |||||||||||||
| Duke Pre- and Post-Training Groups |
|
We obtained cumulative data on equipment utilization represented by the number of patients (participants) examined on a given number of imaging slots available at the MRI units in the time period assessed. Thus no individual data on age, gender, ethnicity are available, reducing the population analyzable for these characteristics to zero.
| ID | Title | Description |
|---|---|---|
| BG000 | Comfort Talk® Training OSU | Three MRI clinical sites form the experimental group at OSU in a randomized assignment. Their personnel was trained to use Comfort Talk® to help patients who are claustrophobic, anxious, and/or cannot lie still to complete their tests at the onset of the study. Comfort Talk® Training: Personnel of MRI units will be trained in advanced rapport skills, patient-centered and hypnoidal language, correct use of suggestions and skills of tension diffusion. This will entail 16 hrs class room work, additional on-site post-training support, and access to a post-training support web module resulting in at least 20 hrs training. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Customized |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Equipment Utilization Q4FY15 = Baseline Quarter (OSU) | Quarterly completion rate of MRIs as a proportion of scans completed per given number of imaging slots available | Imaging slots available in the quarter | Posted | Number | Proportion of completed scans per slots | 1 quarter | Imaging slots | Imaging slots |
|
One year starting with the training
Adverse events were monitored during the training days of the MRI teams. Then assessment was non-systematic in that we would have reported adverse events if they had become known or being collected after training. Patients at risk were only those in the post-training period who showed up at the facility including those who completed their scans and also those who did not.
Number of deaths was not specifically monitored.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Comfort Talk® Training (OSU) | Three MRI clinical sites form the experimental group. Their personnel was trained to use Comfort Talk® to help patients who are claustrophobic, anxious, and/or cannot lie still to complete their tests at the onset of the study. Comfort Talk® Training: Personnel of MRI units will be trained in advanced rapport skills, patient-centered and hypnoidal language, correct use of suggestions and skills of tension diffusion. This will entail 16 hrs classroom work, additional on-site post-training support, and access to a post-training support web module resulting in at least 20 hrs training. |
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Because of considerable staff cuts at Duke right personnel rotated among all sites so that randomization based on training could not be maintained. Therefore a pre/post training comparison was done. OSU collected data electronically, Duke by diary.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Elvira V. Lang, MD (PI of SBIR grant sponsoring site-PIs); CEO | Hypnalgesics, LLC d/b/a Comfort Talk | 617 734 9087 | drevlang@ComfortTalk.com |
| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Aug 13, 2015 | Aug 6, 2019 | Prot_000.pdf |
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| ID | Term |
|---|---|
| D000098452 | Claustrophobia |
| D017060 | Patient Satisfaction |
| ID | Term |
|---|---|
| D010698 | Phobic Disorders |
| D001008 | Anxiety Disorders |
| D001523 | Mental Disorders |
| D000074822 | Treatment Adherence and Compliance |
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| ID | Term |
|---|---|
| D004304 | Dosage Forms |
| ID | Term |
|---|---|
| D004364 | Pharmaceutical Preparations |
| D013678 | Technology, Pharmaceutical |
| D008919 | Investigative Techniques |
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The original model was to have parallel randomized MRI sites. This was possible at one participating institution, The Ohio State Universty Medical Center (OSU). For the second institution (Duke University) staff cuts resulted in personnel cross-over between test and control sites making randomization impossible. Therefore a sequential model was used compared data from the pre- to post training period for the Duke sites. In total 12 MRI entities contributed, six at OSU, and six at Duke. Also, Duke and OSU turned out to have different modes of data collection. OSU had fully automated capture of patients scheduled, showing, and completing their examination as well as a priori numbers of available imaging slots per time unit. Duke did not collect these data electronically so that personnel could only gather the pertinent measures by daily manual diary entry. Thus the mode of result presentation is not concordant in some aspects among sites.
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|
|
| 1 quarter |
| No-shows in Q2FY16 (OSU) | Quarterly number of scheduled patients who do not show up for their appointments | 1 quarter |
| No-shows in Q3FY16 (OSU) | Quarterly number of scheduled patients who do not show up for their appointments | 1 quarter |
| Trend of No-shows Over All Quarters (OSU) | Quarterly number of scheduled patients who do not show up for their appointments | 4 quarters |
| Patient Satisfaction Ranking in Q4FY15 = Baseline Quarter (OSU) | Quarterly percentile rankings of patients' "Overall Assesment" of their satisfaction on a national clinical survey instrument (Press Ganey). Percentile rankings are benchmarked on 1,028 MRI sites nationally, given in raw scores between 0 (worst) to 100 (best). The percentile rankings are based on the number of participants returning surveys in each group. | 1 quarter |
| Patient Satisfaction in Q1FY16 (OSU) | Quarterly percentile rankings of patients' "Overall Assesment" of their satisfaction on a national clinical survey instrument (Press Ganey). Percentile rankings are benchmarked on 1,028 MRI sites nationally, given in raw scores between 0 (worst) to 100 (best). The percentile rankings are based on the number of participants returning surveys in each group. | 1 quarter |
| Patient Satisfaction Ranking in Q2FY16 (OSU) | Quarterly percentile rankings of patients' "Overall Assesment" of their satisfaction on a national clinical survey instrument (Press Ganey). Percentile rankings are benchmarked on 1,028 MRI sites nationally, given in raw scores between 0 (worst) to 100 (best). The percentile rankings are based on the number of participants returning surveys in each group. | 1 quarter |
| Patient Satisfaction Ranking in Q3FY16 (OSU) | Quarterly percentile rankings of patients' "Overall Assesment" of their satisfaction on a national clinical survey instrument (Press Ganey). Percentile rankings are benchmarked on 1,028 MRI sites nationally, given in raw scores between 0 (worst) to 100 (best). The percentile rankings are based on the number of participants returning surveys in each group. | 1 quarter |
| Oral Sedation Rate (Duke) | Patients who receive medical sedation on site | 9 months (3 months baseline, 6 months post training) |
| IV Sedation Rate (Duke) | Number of patients who receive intravenous (IV) sedation on site | 9 months (3 months baseline, 6 months post training) |
| General Anesthesia Rate (Duke) | Number of patients who receive general anesthesia on site | 9 months (3 months baseline, 6 months post training) |
| Disruptive Motion (Duke) | Patients on site who disrupt the scan by motion | 9 months (3 months baseline, 6 months post training) |
| No-shows (Duke) | Scheduled patients who do not show for their MRI examinations. | 9 months (3 months baseline, 6 months post training) |
| Durham |
| North Carolina |
| 27710 |
| United States |
| Ohio State University Medical Center | Columbus | Ohio | 43210 | United States |
| 23471099 | Background | Lang EV. A Better Patient Experience Through Better Communication. J Radiol Nurs. 2012 Dec 1;31(4):114-119. doi: 10.1016/j.jradnu.2012.08.001. |
| 21474702 | Background | Flory N, Lang EV. Distress in the radiology waiting room. Radiology. 2011 Jul;260(1):166-73. doi: 10.1148/radiol.11102211. Epub 2011 Apr 7. |
| 15733657 | Background | Lang EV, Hatsiopoulou O, Koch T, Berbaum K, Lutgendorf S, Kettenmann E, Logan H, Kaptchuk TJ. Can words hurt? Patient-provider interactions during invasive procedures. Pain. 2005 Mar;114(1-2):303-9. doi: 10.1016/j.pain.2004.12.028. Epub 2005 Jan 26. |
| 11818602 | Background | Lang EV, Rosen MP. Cost analysis of adjunct hypnosis with sedation during outpatient interventional radiologic procedures. Radiology. 2002 Feb;222(2):375-82. doi: 10.1148/radiol.2222010528. |
| 10801169 | Background | Lang EV, Benotsch EG, Fick LJ, Lutgendorf S, Berbaum ML, Berbaum KS, Logan H, Spiegel D. Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial. Lancet. 2000 Apr 29;355(9214):1486-90. doi: 10.1016/S0140-6736(00)02162-0. |
| 27126735 | Background | Norbash A, Yucel K, Yuh W, Doros G, Ajam A, Lang E, Pauker S, Mayr N. Effect of team training on improving MRI study completion rates and no-show rates. J Magn Reson Imaging. 2016 Oct;44(4):1040-7. doi: 10.1002/jmri.25219. Epub 2016 Apr 6. |
| 28461168 | Result | Ajam AA, Nguyen XV, Kelly RA, Ladapo JA, Lang EV. Effects of Interpersonal Skills Training on MRI Operations in a Saturated Market: A Randomized Trial. J Am Coll Radiol. 2017 Jul;14(7):963-970. doi: 10.1016/j.jacr.2017.03.015. Epub 2017 Apr 28. |
| 29530323 | Result | Ladapo JA, Spritzer CE, Nguyen XV, Pool J, Lang E. Economics of MRI Operations After Implementation of Interpersonal Skills Training. J Am Coll Radiol. 2018 Dec;15(12):1775-1783. doi: 10.1016/j.jacr.2018.01.017. Epub 2018 Mar 9. |
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| NOT COMPLETED |
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| NOT COMPLETED |
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| NOT COMPLETED |
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| BG001 | Control OSU | Three MRI sites at OSU were not trained in Comfort Talk®. |
| BG002 | Total | Total of all reporting groups |
| Imaging Slots |
|
| Participants |
| Sex: Female, Male | Participants |
|
| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Participants |
| OG001 | Control | MRI sites not trained in Comfort Talk®. |
|
|
| Primary | Equipment Utilization in Q1FY16 (OSU) | Quarterly completion rate of MRIs as a proportion of scans completed per given number of imaging slots available | Participants completing their scans | Posted | Number | Proportion of completed scans per slots | 1 quarter | Imaging slots | Imaging slots |
|
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|
|
| Primary | Equipment Utilization in Q2FY16 (OSU) | Quarterly completion rate of MRIs as a proportion of scans completed per given number of imaging slots available | Imaging slots available in the quarter | Posted | Number | Proportion of completed scans per slots | 1 quarter | Imaging Slots | Imaging Slots |
|
|
|
|
| Primary | Equipment Utilization in Q3FY16 (OSU) | Quarterly completion rate of MRIs as a proportion of scans completed per given number of imaging slots available | Imaging slots available in the quarter | Posted | Number | Proportion of completed scans per slots | 1 quarter | Imaging slots | Imaging slots |
|
|
|
|
| Primary | Equipment Utilization Over All Quarters (OSU) | Completion rates of MRIs as a proportion of scans completed per given number of imaging slots available | Imaging slots available | Posted | Number | Proportion of completed scans per slots | 4 quarters | Imaging slots | Imaging slots |
|
|
|
|
| Primary | Incompletions (Duke) | Patients who cannot complete their scan | Patients showing for their MRI scans | Posted | Count of Participants | Participants | 9 months (3 months baseline, 6 months post training) |
|
|
|
|
| Secondary | No-shows in Q4FY15 = Baseline Quarter (OSU) | Quarterly number of scheduled patients who do not show up for their appointments | Scheduled patients | Posted | Count of Participants | Participants | 1 quarter |
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|
| Secondary | No-shows in Q1FY16 (OSU) | Quarterly number of scheduled patients who do not show up for their appointments | Patients scheduled for MRI | Posted | Count of Participants | Participants | 1 quarter |
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| Secondary | No-shows in Q2FY16 (OSU) | Quarterly number of scheduled patients who do not show up for their appointments | Patients scheduled for MRI | Posted | Count of Participants | Participants | 1 quarter |
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|
|
| Secondary | No-shows in Q3FY16 (OSU) | Quarterly number of scheduled patients who do not show up for their appointments | Patients scheduled for MRI | Posted | Count of Participants | Participants | 1 quarter |
|
|
|
|
| Secondary | Trend of No-shows Over All Quarters (OSU) | Quarterly number of scheduled patients who do not show up for their appointments | Patients scheduled for MRI | Posted | Count of Participants | Participants | 4 quarters |
|
|
|
|
| Secondary | Patient Satisfaction Ranking in Q4FY15 = Baseline Quarter (OSU) | Quarterly percentile rankings of patients' "Overall Assesment" of their satisfaction on a national clinical survey instrument (Press Ganey). Percentile rankings are benchmarked on 1,028 MRI sites nationally, given in raw scores between 0 (worst) to 100 (best). The percentile rankings are based on the number of participants returning surveys in each group. | Number of participants who returned surveys during that quarter. | Posted | Mean | Standard Deviation | National Satisfaction Ranking | 1 quarter |
|
|
|
| Secondary | Patient Satisfaction in Q1FY16 (OSU) | Quarterly percentile rankings of patients' "Overall Assesment" of their satisfaction on a national clinical survey instrument (Press Ganey). Percentile rankings are benchmarked on 1,028 MRI sites nationally, given in raw scores between 0 (worst) to 100 (best). The percentile rankings are based on the number of participants returning surveys in each group. | Number of participants who returned surveys during that quarter. | Posted | Mean | Standard Deviation | National Percentile Satisfaction Ranking | 1 quarter |
|
|
|
| Secondary | Patient Satisfaction Ranking in Q2FY16 (OSU) | Quarterly percentile rankings of patients' "Overall Assesment" of their satisfaction on a national clinical survey instrument (Press Ganey). Percentile rankings are benchmarked on 1,028 MRI sites nationally, given in raw scores between 0 (worst) to 100 (best). The percentile rankings are based on the number of participants returning surveys in each group. | Number of participants who returned surveys during that quarter. | Posted | Mean | Standard Deviation | National Percentile Satisfaction Ranking | 1 quarter |
|
|
|
| Secondary | Patient Satisfaction Ranking in Q3FY16 (OSU) | Quarterly percentile rankings of patients' "Overall Assesment" of their satisfaction on a national clinical survey instrument (Press Ganey). Percentile rankings are benchmarked on 1,028 MRI sites nationally, given in raw scores between 0 (worst) to 100 (best). The percentile rankings are based on the number of participants returning surveys in each group. | Number of participants who returned surveys during that quarter. | Posted | Mean | Standard Deviation | National Percentile Satisfaction Ranking | 1 quarter |
|
|
|
| Secondary | Oral Sedation Rate (Duke) | Patients who receive medical sedation on site | Patients showing for their MRI scans | Posted | Count of Participants | Participants | 9 months (3 months baseline, 6 months post training) |
|
|
|
|
| Secondary | IV Sedation Rate (Duke) | Number of patients who receive intravenous (IV) sedation on site | Patients showing for their MRI scans | Posted | Count of Participants | Participants | 9 months (3 months baseline, 6 months post training) |
|
|
|
|
| Secondary | General Anesthesia Rate (Duke) | Number of patients who receive general anesthesia on site | Patients showing for their MRI scans | Posted | Count of Participants | Participants | 9 months (3 months baseline, 6 months post training) |
|
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|
|
| Secondary | Disruptive Motion (Duke) | Patients on site who disrupt the scan by motion | Patients showing for their MRI scans | Posted | Count of Participants | Participants | 9 months (3 months baseline, 6 months post training) |
|
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|
|
| Secondary | No-shows (Duke) | Scheduled patients who do not show for their MRI examinations. | Patients scheduled for MRI scans | Posted | Count of Participants | Participants | 9 months (3 months baseline, 6 months post training) |
|
|
|
|
| 0 |
| 11,650 |
| 0 |
| 11,650 |
| 0 |
| 11,650 |
| EG001 | Control (OSU) | Three MRI sites were not trained in Comfort Talk®. | 0 | 8,605 | 0 | 8,605 | 0 | 8,605 |
| EG002 | Baseline = Control (Duke) | Data from 6 Duke sites at baseline were used as the control in a pre- to post-training comparison | 0 | 4,446 | 0 | 4,446 | 0 | 4,446 |
| EG003 | Comfort Talk® Training (Duke) | The same 6 Duke sites represented at baseline formed the experimental group after Comfort Talk training in a pre- to post- training comparison | 0 | 9,658 | 0 | 9,658 | 0 | 9,658 |
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| D015438 | Health Behavior |
| D001519 | Behavior |
| Chi-squared, Corrected |
| 0.3037 |
Bonferroni-corrected p-values were used after multiplying the uncorrected p-value by 10. |
| Superiority |
| Change in the average quarterly completion rate as compared to the baseline quarter | Chi-squared, Corrected | <0.01 | Bonferroni-corrected p-values were used after multiplying the uncorrected p-value by 10. | Superiority |
| Chi-squared |
| 0.2010 |
Bonferroni-correction was not done since the corrected p-value would be have been greater than 1. |
| Superiority |
| Change in the average quarterly completion rate as compared to the baseline quarter | Chi-squared | <0.001 | Bonferroni-corrected p-values were used after multiplying the uncorrected p-value by 10. | Superiority |
| Chi-squared |
| 0.303 |
Bonferroni-corrected p-values were used after multiplying the uncorrected p-value by 10. Chi-square analysis was used to assess equipment utilization at trained sites compared with untrained sites when stratifying by time (chi-square MH = 858.2). |
| Superiority |
| Change in the average quarterly completion rate as compared to the baseline quarter | Chi-squared, Corrected | <0.001 | Bonferroni-corrected p-values were used after multiplying the uncorrected p-value by 10. | Superiority |
| Chi-squared |
| 0.8523 |
No Bonferroni-correction |
| Superiority |
| Change in the quarterly average no-show rate as compared to the baseline quarter at untrained sites | Chi-squared | 0.5883 | Bonferroni-correction was not done for this nonsignificant result since the corrected p-value would be have been greater than 1, which is not possible. | Superiority |
| Chi-squared |
| 0.276 |
No Bonferroni-correction |
| Superiority |
| Change in the quarterly no-shows as compared to the baseline quarter at untrained sites | Chi-squared | 0.2764 | No Bonferroni-correction | Superiority |
| Chi-squared |
| 0.9012 |
Bonferroni-correction was not done since the corrected p-value would be have been greater than 1. |
| Superiority |
| Change in the quarterly average no-show rate as compared to the baseline quarter for untrained sites | Chi-squared, Corrected | 0.9065 | Bonferroni-corrected p-values were used after multiplying the uncorrected p-value by 10. | Superiority |