Abstract
IntroductionCerebral palsy (CP) is the most common childhood physical disability. Accurate diagnosis before 6 months is possible using predictive tools and decision-making skills. Yet diagnosis is typically made at 12–24 months of age, hindering access to early interventions that improve functional outcomes. Change in practice is required for physicians in key diagnostic behaviours. This study aims to close the identified research–practice gap and increase accurate CP diagnosis before 6 months of age through tailored web-based implementation interventions. This trial will determine whether adaptive e-learning using virtual patients, targeting CP diagnostic behaviours and clinical decision-making skills, effectively changes physician behaviour and practice compared with non-adaptive e-learning instructional design or control.Methods and analysisThis study is a 3-arm parallel superiority randomised controlled trial of two tailored e-learning interventions developed to expedite physician CP diagnosis. The trial will compare adaptive (arm 1) and non-adaptive (arm 2) instructional designs with waitlist control (arm 3) to evaluate change in physician behaviour, skills and diagnostic practice. A sample size of 275 paediatric physicians enables detection of small magnitude effects (0.2) of primary outcomes between intervention comparators with 90% power (α=0.05), allowing for 30% attrition. Barrier analysis, Delphi survey, Behaviour Change Wheel and learning theory frameworks guided the intervention designs. Adaptive and non-adaptive video and navigation sequences utilising virtual patients and clinical practice guideline content were developed, integrating formative key features assessment targeting clinical decision-making skills relative to CP diagnosis.Physician outcomes will be evaluated based on postintervention key feature examination scores plus preintervention/postintervention behavioural intentions and practice measures. Associations with CP population registers will evaluate real-world diagnostic patient outcomes. Intervention costs will be reported in a cost–consequence analysis from funders’ and societal perspectives.Ethics and disseminationEthics approved from The University of Sydney (Project number 2021/386). Results will be disseminated through peer-reviewed journals and scientific conferences.Trial registration numberAustralian New Zealand Clinical Trials Registry: ACTRN 12622000184774.
Reference109 articles.
1. Australian Cerebral Palsy Register Group, The Australian Cerebral Palsy Register 2020 Bulletin . Rates and trends for prenatally and perinatally acquired cerebral palsy, birth years 1995 - 2014. Sydney, Australia Cerebral Palsy Alliance; 2020. https://cpregister.com/wp-content/uploads/2020/10/ACPR-Report-2020-Bulletin_s_lr.pdf [Accessed 02 Jan 2022].
2. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment;Novak;JAMA Pediatr,2017
3. Epidemiology of cerebral palsy in Bangladesh: a population‐based surveillance study;Khandaker;Dev Med Child Neurol,2019
4. Australian Cerebral Palsy Register Group . Report of the Australian cerebral palsy register birth years 1995-2012. North Adelaide, Australia; 2018, Australian Cerebral Palsy Register. https://cpregister.com/wp-content/uploads/2019/02/Report-of-the-Australian-Cerebral-Palsy-Register-Birth-Years-1995-2012.pdf [Accessed 02 Jan 2022].
5. Harnessing activity-dependent plasticity to repair the damaged corticospinal tract in an animal model of cerebral palsy;Martin;Dev Med and Child Neurol,2011
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