AI decision support to help emergency doctors detect and manage acute kidney injury
Transforming Kidney Care in the Emergency Department: A Prospective Effectiveness-Implementation Evaluation
This project will test whether an AI-based tool helps emergency doctors find and manage acute kidney injury earlier in adults who have blood creatinine measured during their ED visit.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 200000 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Johns Hopkins University Academic / other |
| Locations | 1 site (Baltimore, Maryland) |
| Trial ID | NCT06840210 on ClinicalTrials.gov |
What this trial studies
The project introduces an AI-powered clinical decision support (CDS) tool into three emergency departments using a phased rollout that first collects baseline data with the tool running silently and then activates alerts for clinicians after training. Researchers will track how often clinicians use the tool and measure process outcomes such as earlier AKI identification, avoidance of potentially harmful medications, and changes in hospitalization decisions. Clinical outcomes including new or progressive AKI will be analyzed, with secondary analyses limited to patients who have repeat creatinine testing within 72 hours. The design is observational and focused on real-world implementation and effectiveness in routine ED care.
Who should consider this trial
Good fit: Adults (age ≥18) who present to one of the participating EDs and have at least one serum creatinine measured during the ED visit (and a repeat creatinine within 72 hours for some analyses) are eligible for inclusion.
Not a fit: Patients who do not have a creatinine measured during the ED visit, those discharged without follow-up labs, pediatric patients, and people treated outside the participating sites are unlikely to receive benefit from the tool in this project.
Why it matters
Potential benefit: If successful, the tool could help clinicians detect AKI sooner, reduce exposure to kidney-harming medications, and improve short-term kidney outcomes for ED patients.
How similar studies have performed: Previous machine-learning and alert-based AKI tools have shown promise in retrospective analyses and small implementations, but real-world impact has been mixed and needs careful implementation evaluation.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: Participants must meet all of the following conditions to be eligible for the study: 1. Emergency Department Visit Patients presenting to one of the three study site emergency departments (EDs): Johns Hopkins Hospital (JHH) Bayview Medical Center (BMC) Howard County General Hospital (HCGH) Serum Creatinine Measurement 2. At least one serum creatinine (sCr) test performed during the ED visit. 3. Age: Adults (≥18 years old) at the time of ED visit. 4. Follow-Up Data Available: To be included in analysis for the investigator's secondary effectiveness outcome (new or progressive AKI) patients must have repeat creatinine concentration measurement available within 72 hours Exclusion Criteria: 1. No ED Serum Creatinine Data: Patients who do not have a measured serum creatinine (sCr) value during the ED visit will not have decision support provided during the ED stay. 2. Patients Discharged Without Follow-Up Data: Patients discharged from the ED who do not undergo a follow-up serum creatinine test within 72 hours will be excluded from analysis of new or progressive AKI outcome assessment. 3. Age \<18 Years 4. End-Stage Kidney Disease (ESKD) or Chronic Dialysis: Patients with a documented history of end-stage kidney disease (ESKD), (patients receiving chronic dialysis (hemodialysis or peritoneal dialysis) will will be excluded from analysis of new or progressive AKI outcome assessment).
Where this trial is running
Baltimore, Maryland
- Johns Hopkins Hospital — Baltimore, Maryland, United States (Recruiting)
Study contacts
- Principal investigator: Eili Klein, PhD — Johns Hopkins University
- Study coordinator: Eili Y Klein, PhD
- Email: eklein@jhmi.edu
- Phone: 732-266-7732
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.