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Latent Tuberculosis infection (LTBI) guidelines can be complex. LTBI-ASSIST is a web-based interactive tool to navigate US LTBI clinical practice guidelines in a patient-centered format that may guide clinical decision making around Latent TB care.
The research goal is to determine the difference in reported confidence among trainees that are not experts in LTBI care. The investigators further aim to assess if access to the LTBI-ASSIST tool improves clinical decision making in a series of simulated case scenarios containing guideline-derived, multiple choice items, as well as assess the efficiency in navigating the scenarios - measured by time to complete the survey.
The investigators proposed a randomized study design, in which an electronic survey/questionnaire with 4 case scenarios consisting of 14 multiple choice questions. Participants providing informed consent will be randomized to receiving access to either US Centers for Disease Control (CDC)/National Tuberculosis (TB) Controllers Association (NTCA) Guidelines or the LTBI-ASSIST online tool. Those in the experimental arm will further complete a 10 question System Usability Scale to assess usability of the LTBI-ASSIST tool.
All Johns Hopkins medical trainees and residents will be eligible to participate.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CDC/NTCA guidelines only | Active Comparator | The control group will have a link to US guidelines only and use it as a resource to answer the case vignettes. |
|
| LTBI ASSIST and CDC/NTCA guidelines | Experimental | The intervention group will have a link to both US guidelines, and the LTBI-ASSIST tool as resources to answer the case vignettes. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CDC/NTCA guidelines only | Behavioral | The control group will have a link to US guidelines only. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Reported confidence with LTBI management [using a Likert scale questionnaire developed by study team] | The primary outcome will be the change in reported confidence with LTBI management, comparing between the control and intervention group. This outcome will be measured using a Likert Scale questionnaire administered pre- and post-intervention asking trainees to rate their confidence in performing critical LTBI care proficiencies. | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of appropriate LTBI care selection | The number of multiple choice questions answered correctly in the case scenarios comparing between trainees and/or CDC/NTCA guidelines. | 3 months |
| Time to LTBI care selection |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Maunank Shah, MD, PhD | Hopkins University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Johns Hopkins | Baltimore | Maryland | 21224 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38062221 | Derived | Starke SJ, Martinez Rivera MB, Krishnan S, Shah M. Randomized Controlled Trial of Clinical Guidelines Versus Interactive Decision-Support for Improving Medical Trainees' Confidence with Latent Tuberculosis Care. J Gen Intern Med. 2024 May;39(6):951-959. doi: 10.1007/s11606-023-08551-3. Epub 2023 Dec 7. |
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| ID | Term |
|---|---|
| D055985 | Latent Tuberculosis |
| D014376 | Tuberculosis |
| ID | Term |
|---|---|
| D009164 | Mycobacterium Infections |
| D000193 | Actinomycetales Infections |
| D016908 | Gram-Positive Bacterial Infections |
| D001424 | Bacterial Infections |
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| LTBI ASSIST and CDC/NTCA guidelines only | Behavioral | The intervention group will have a link to both US guidelines, and the LTBI-ASSIST tool. |
|
The time required for each group to reach a correct answer.
| 3 months |
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
| D000085343 | Latent Infection |