Clinical Decision Support for Newborn Weight Loss: A Randomized Controlled Trial

BACKGROUND AND OBJECTIVE: The Newborn Weight Tool (NEWT) can inform newborn feeding decisions and might reduce health care utilization by preventing excess weight loss. Clinical decision support (CDS) displaying NEWT might facilitate its use. Our study’s objective is to determine the effect of CDS displaying NEWT on feeding and health care utilization. METHODS: At an hospital involved in NEWT development, we randomly assigned 2682 healthy infants born $36 weeks gestation in 2018–2019 either to CDS displaying NEWT with an electronic flag if most recent weight was $75th weight loss centile or to a control of usual care with NEWT accessed at clinician discretion. Our primary outcome was feeding type concordant with weight loss, defined as exclusive breastfeeding for those not flagged, exclusive breastfeeding or supplementation for those flagged once, and supplementation for those flagged more than once. Secondary outcomes included inpatient and outpatient utilization in the first 30 days. We used v2 and Student’s t tests to compare intervention infants with control and to compare trial infants with those born in 2017. RESULTS: Feeding was concordant with for 1854 (74.5%) trial infants and did not differ between randomized groups (P = .65); concordant feeding was higher for all trial infants than for infants born in 2017 (64.4%; P < .0005). Readmission occurred for 51 (3.8%) CDS infants and 45 (3.4%) control infants (P = .56). Among the 60% of trial infants with outpatient records available, there were 3.5 ± 1.7 visits with no differences between randomized groups (P = .10). CONCLUSIONS: At an hospital involved in NEWT development, CDS displaying NEWT did not alter either feeding or health care utilization compared with discretionary NEWT access.

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Work Title Clinical Decision Support for Newborn Weight Loss: A Randomized Controlled Trial
Access
Open Access
Creators
  1. Valerie J. Flaherman
  2. Andrew Robinson
  3. Jennifer Creasman
  4. Charles E. McCulloch
  5. Ian M. Paul
  6. Mark J. Pletcher
Keyword
  1. newborn weight loss tools (NEWTS)
  2. clinical decision support
  3. weight reduction
License In Copyright (Rights Reserved)
Work Type Article
Publisher
  1. Hospital pediatrics
Publication Date May 25, 2022
Publisher Identifier (DOI)
  1. https://doi.org/10.1542/hpeds.2021-006470
Deposited August 12, 2024

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Version 1
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  • Created
  • Added 2022_Clinical_Decision_Support_Newborn_Weight_Loss_Hospital_Pediatrics.pdf
  • Added Creator Valerie J. Flaherman
  • Added Creator Andrew Robinson
  • Added Creator Jennifer Creasman
  • Added Creator Charles E. McCulloch
  • Added Creator Ian M. Paul
  • Added Creator Mark J. Pletcher
  • Published
  • Updated
  • Updated Publication Date Show Changes
    Publication Date
    • 2022-06-01
    • 2022-05-25
  • Updated Keyword Show Changes
    Keyword
    • newborn weight loss tools (NEWTS), clinical decision support, weight reduction