# RFA-CK20-003: In silico Randomized Control Trial Framework for Assessing Infection Control and Prevention Interventions in the Hospital

> **NIH ALLCDC U01** · CENTER/ DISEASE DYNAMICS, ECONOM/POLICY · 2024 · $600,000

## Abstract

Project Summary/Abstract
Multidrug-resistant organisms (MDROs), particularly carbapenem-resistant organisms (CROs),
are a major cause of healthcare-associated infections (HAIs). Though studies have found
multiple interventions addressing MDRO colonization and transmission to be effective at
reducing HAIs, implementation has lagged due to uncertainty regarding the most efficacious
combinations of interventions. As patients are connected within healthcare facilities by the
movement of healthcare workers (HCWs) and mobile equipment, evaluation of an intervention's
impact on transmission and infection must consider these network dynamics. Additionally, each
institution has its own staffing ratios, equipment management, and cleaning practices that
inform the efficacy of an intervention. To address knowledge gaps regarding the most effective
combinations of intervention strategies at an individual hospital, we will build a model
framework that will provide hospital administrators and infection control experts with tools for
quantifying individual patient risk factors for colonization and infection and for comparing the
potential effectiveness of interventions to control HAIs. The aims of the project are: (1) to
develop models to predict which patients are at highest risk for colonization and infection with
MDROs using clinically relevant information collected during the normal course of care
combined with operational data on staffing and equipment movement; (2) to utilize hospital-
level models to quantify the combinatorial relationship between, and marginal impact of,
additional interventions to reduce HAIs; and (3) to build a framework for other hospitals and
healthcare systems to examine the effectiveness of interventions parameterized by their own
institution's data. Models will start with the patient at the center, utilizing the rich covariate data
stored in electronic health records to develop prediction models based on advanced machine
learning. These prediction models will be translatable tools that can be directly incorporated
into clinical care to assist clinicians in preventing HAIs. Data on patient-connectedness will
form the foundation of hospital-level models that will allow for detailed examinations of the
effectiveness of different combinations of interventions. Finally, a generalizable framework will
be constructed and tested across a network of healthcare facilities. These models will directly
inform CDC guidelines about MDRO prevention and aid clinicians in reducing the risk of HAIs.

## Key facts

- **NIH application ID:** 11031913
- **Project number:** 5U01CK000589-05
- **Recipient organization:** CENTER/ DISEASE DYNAMICS, ECONOM/POLICY
- **Principal Investigator:** Eili Ya'akov Klein
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2024
- **Award amount:** $600,000
- **Award type:** 5
- **Project period:** 2020-08-01 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11031913

## Citation

> US National Institutes of Health, RePORTER application 11031913, RFA-CK20-003: In silico Randomized Control Trial Framework for Assessing Infection Control and Prevention Interventions in the Hospital (5U01CK000589-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/11031913. Licensed CC0.

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