Clinician JUdgment Versus Risk Score to Predict Stroke outComes: The JURASSIC Clinical Trial

NCT ID: NCT01657279

Last Updated: 2012-10-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

111 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-07-31

Study Completion Date

2012-08-31

Brief Summary

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Background: Several risk score models are now available to assist clinicians estimate outcomes after an acute ischemic stroke. Limited information is available on the predictive value of these scores compared to real outcomes and clinical judgment.

Objectives: To compare clinician judgment with the use of a validated stroke risk score (iScore) and patients' outcomes.

Detailed Description

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A convenience sample of 111 practicing clinicians (general and vascular neurologists, internists, and ER physicians) predicted the outcomes of 5 stroke patients based on case summaries. Cases were randomly selected as being representative of the 10 most common clinical scenarios (n=1,415) from a pool of over 12,000 patients admitted to stroke centers in Ontario, Canada. Stroke cases had known clinical presentation, comorbidities, stroke severity, and outcomes.

All participants are active practicing physicians caring for patients with acute stroke. Conditions were standardized to mimic clinical practice.

Main outcomes of interest included 30-day mortality and death or disability at discharge.

Secondary outcome: death or institutionalization at discharge

Conditions

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Stroke Ischemic Stroke Cerebrovascular Disease

Keywords

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stroke risk score iScore outcomes mortality disability institutionalization

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Randomized clinical scenarios

Clinicians are randomized to a sequence of 5 clinical scenarios

Group Type EXPERIMENTAL

Clinical scenarios

Intervention Type OTHER

Clinicians will be randomized to a sequence of 5 clinical scenarios with a variable range of expected outcome \[i.e. from low (\<10%) to high (\>50%) expected risk death at 30 days\].

Interventions

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Clinical scenarios

Clinicians will be randomized to a sequence of 5 clinical scenarios with a variable range of expected outcome \[i.e. from low (\<10%) to high (\>50%) expected risk death at 30 days\].

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Practicing and active physicians managing patients with stroke

Exclusion Criteria

* retired physicians
* physicians not exposed to care for stroke patients
Minimum Eligible Age

20 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Heart and Stroke Foundation of Ontario

OTHER

Sponsor Role collaborator

Unity Health Toronto

OTHER

Sponsor Role lead

Responsible Party

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Gustavo Saposnik

Staff Physician and Clinician Scientist, Associate Professor of medicine, University of Toronto

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gustavo Saposnik, MD MSc FRCPC

Role: PRINCIPAL_INVESTIGATOR

Unity Health Toronto

Locations

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Duke University Medical Center

Durham, North Carolina, United States

Site Status

Sunnybrook Health Sciences Centre

Toronto, Ontario, Canada

Site Status

St Michael's Hospital

Toronto, Ontario, Canada

Site Status

McGill University Health Centre

Montreal, Quebec, Canada

Site Status

Countries

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United States Canada

References

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Saposnik G, Fang J, Kapral MK, Tu JV, Mamdani M, Austin P, Johnston SC; Investigators of the Registry of the Canadian Stroke Network (RCSN); Stroke Outcomes Research Canada (SORCan) Working Group. The iScore predicts effectiveness of thrombolytic therapy for acute ischemic stroke. Stroke. 2012 May;43(5):1315-22. doi: 10.1161/STROKEAHA.111.646265. Epub 2012 Feb 3.

Reference Type BACKGROUND
PMID: 22308252 (View on PubMed)

Saposnik G, Raptis S, Kapral MK, Liu Y, Tu JV, Mamdani M, Austin PC; Investigators of the Registry of the Canadian Stroke Network and the Stroke Outcome Research Canada Working Group. The iScore predicts poor functional outcomes early after hospitalization for an acute ischemic stroke. Stroke. 2011 Dec;42(12):3421-8. doi: 10.1161/STROKEAHA.111.623116. Epub 2011 Sep 29.

Reference Type BACKGROUND
PMID: 21960583 (View on PubMed)

Saposnik G, Kapral MK, Liu Y, Hall R, O'Donnell M, Raptis S, Tu JV, Mamdani M, Austin PC; Investigators of the Registry of the Canadian Stroke Network; Stroke Outcomes Research Canada (SORCan) Working Group. IScore: a risk score to predict death early after hospitalization for an acute ischemic stroke. Circulation. 2011 Feb 22;123(7):739-49. doi: 10.1161/CIRCULATIONAHA.110.983353. Epub 2011 Feb 7.

Reference Type BACKGROUND
PMID: 21300951 (View on PubMed)

Related Links

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http://www.sorcan.ca/iscore/

Web based tool for estimating outcomes using the iScore to compare clinicians' estimations

Other Identifiers

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09-020

Identifier Type: OTHER

Identifier Source: secondary_id

SMH 09-020

Identifier Type: -

Identifier Source: org_study_id