Development of the individualised Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education (iCOMPARE) trial: a protocol summary of a national cluster-randomised trial of resident duty hour policies in internal medicine

BMJ Open
Judy A SheaiCOMPARE Research Group

Abstract

Medical trainees' duty hours have received attention globally; restrictions in Europe, New Zealand and some Canadian provinces are much lower than the 80 hours per week enforced in USA. In USA, resident duty hours have been implemented without evidence simultaneously reflecting competing concerns about patient safety and physician education. The objective is to prospectively evaluate the implications of alternative resident duty hour rules for patient safety, trainee education and intern sleep and alertness. 63 US internal medicine training programmes were randomly assigned 1:1 to the 2011 Accreditation Council for Graduate Medical Education resident duty hour rules or to rules more flexible in intern shift length and number of hours off between shifts for academic year 2015-2016. The primary outcome is calculated for each programme as the difference in 30-day mortality rate among Medicare beneficiaries with any of several prespecified principal diagnoses in the intervention year minus 30-day mortality in the preintervention year among Medicare beneficiaries with any of several prespecified principal diagnoses. Additional safety outcomes include readmission rates, prolonged length of stay and costs. Measures derived from traine...Continue Reading

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Citations

Aug 17, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Kimberly A SelzmanKenneth Cavanaugh
Mar 12, 2019·The New England Journal of Medicine·Mathias BasnerUNKNOWN iCOMPARE Research Group
Mar 12, 2019·The New England Journal of Medicine·Jeffrey H SilberUNKNOWN iCOMPARE Research Group

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Software Mentioned

ICOMPARE
SAS
STATA
Flex

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