Research: Project Summary - yina/2025-catalyzing-health-promptathon GitHub Wiki

Tasks

Task	Goal	Prompt
Draft	Draft a full specific aims page based on the project summary provided	Based on the project summary write an intial NIH R01 style specific aims page
Evaluate	Identify potential weaknesses of this proposed study	What might be weaknesses to this proposed study?
Identify alternatives	Generate alternative designs that address potential weaknesses	What are potential modifications or alternatives to this study to overcome the potential weaknesses?
Enhance	Propose rigorous measures for the study	What would be additional study measures that can be used to evaluate the study hypotheses?
Contextualize	Identify relevant literature that would strengthen the proposal	Improve the background and significance section of the specific aims page. Add supporting references.
Optimize	Test various language, format, styles, “voices”, to enhance the proposal	Make the tone more scientific. Make the tone more colloquial. Add a stronger narrative voice to the proposal. Reorganize the structure of the proposal in 3 different ways for me to compare.
Compare	Compare the proposal to the original and evaluate pros/cons	Compare the proposal to this specific aims page “””xxx”””. Which is more likely to get funded by the NIH.

Project Summary

As the nation continues its efforts to contain healthcare costs and improve quality, healthcare information
technology provides some of our most potent yet underutilized tools. Clinical prediction rules are frontline
decision aids that combine state-of-the-art evidence with real-time patient history, physical examination, and
laboratory data. While often well-validated, clinical prediction rules have been underutilized in practice.
Recently, our team developed the integrated clinical prediction rule (iCPR) system, embedding CPRs within
the nation’s largest commercial electronic health record (EHR) system. Using this novel system, we
demonstrated high rates of provider utilization and a significant reduction in antibiotic prescribing and
diagnostic test ordering among suspected cases of strep throat and pneumonia at a single healthcare facility.
The objective of the proposed project is to generalize this platform across diverse settings and create a toolkit
for further dissemination. Building on the success of the original iCPR project, the specific aims of this proposal
are to (1) integrate our previously tested and refined iCPR tool into the same commercial EHR in three different
clinical settings, adapting the innovation to provider preference, culture, and local workflow rather than
imposing a rigidly standardized tool, (2) identify and measure rate and variability of iCPR uptake across
different settings, (3) determine iCPR impact on antibiotic prescribing and diagnostic test-ordering patterns
across diverse clinical settings with a randomized controlled trial, and (4) use a well-established theory-driven
implementation framework to identify facilitators and barriers to integration in each setting, and develop a
toolkit for adapting and implementing the tool in diverse settings. To achieve these aims, we propose a five-
year study in which we first adapt, integrate and usability-test the original iCPR at three new diverse sites. We
will then conduct a two-year randomized controlled trial with a one-year post-trial open-access observation
period to determine the persistence of: 1) the tool’s utilization and 2) its impact on antibiotic- and test-ordering
in patients with suspected strep throat or pneumonia. In the final year, study findings will be compiled into a
toolkit so that any healthcare facility using the Epic EHR can integrate iCPR into its ambulatory workflow. The
study uses several innovative and significant approaches, including: 1) adapting the nation’s most widespread
commercial EHR system; 2) building the new tool with “off-the-shelf” technology included in every Epic EHR
package, so the innovation can be easily ported to all Epic EHR users; 3) using highly specific, well-validated
clinical prediction rules as its core content; 4) guiding the integration process with highly generalizable usability
testing techniques; and 5) using a hybrid RE-AIM and normalization process theory implementation evaluation
framework. Together, these innovative approaches make iCPR uniquely suited to overcome longstanding
barriers and integrate and disseminate evidence-based tools into the primary care workflow at the point of care
in real time.