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

Area of Science:

• Neonatal care
• Clinical informatics
• Public health

Background:

• The Newborn Weight Tool (NEWT) aids feeding decisions and may prevent excess newborn weight loss, reducing healthcare utilization.
• Clinical decision support (CDS) integrating NEWT could improve its application.

Purpose of the Study:

• To evaluate the impact of CDS displaying NEWT on infant feeding and healthcare utilization.

Main Methods:

• A randomized trial assigned 2682 healthy infants to either CDS with NEWT electronic flagging or usual care with discretionary NEWT access.
• Primary outcome: feeding type concordant with weight loss. Secondary outcomes: 30-day inpatient and outpatient healthcare utilization.
• Statistical analysis included chi-squared and Student's t tests.

Main Results:

• Concordant feeding occurred in 74.5% of trial infants, with no difference between randomized groups (P = .65). Overall concordant feeding was higher in trial infants compared to a historical cohort (64.4%, P < .0005).
• Readmission rates were similar: 3.8% for CDS infants versus 3.4% for control infants (P = .56).
• Outpatient visits averaged 3.5 ± 1.7, with no significant difference between groups (P = .10).

Conclusions:

• CDS displaying NEWT did not significantly alter feeding practices or healthcare utilization compared to discretionary NEWT access in this hospital setting.
• The findings suggest that integrating NEWT into CDS does not automatically change clinical practice outcomes for newborn weight management.